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Erschienen in: Osteoporosis International 4/2007

01.04.2007 | Original Article

Bone microarchitecture in males with corticosteroid-induced osteoporosis

verfasst von: D. Chappard, N. Josselin, C. Rougé-Maillart, E. Legrand, M. F. Baslé, M. Audran

Erschienen in: Osteoporosis International | Ausgabe 4/2007

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Abstract

Summary

Microarchitectural changes in trabecular bone were analyzed by microcomputed tomography (microCT) and histomorphometry in 24 patients with corticosteroid-induced osteoporosis. The microCT images revealed a reduction in trabecular thickness only on frequency distribution curves, with no increase in trabecular separation. Trabecular plate thinning and perforations were easily identified.

Introduction

Corticosteroid-induced osteoporosis (CSIOP) is mediated by direct actions of the drug on bone cells. The result is a decrease in trabecular bone mass and a reduction in trabecular thickness, but connectivity is believed to remain rather well preserved.

Methods

Twenty-four transiliac bone biopsies from patients with CSIOP were studied conjointly by histomorphometry [with two-dimensional (2D) architectural descriptors] and microCT (with 3D analysis of trabecular characteristics, including trabecular thickness and separation). The frequency distribution of thickness and separation were compared with data obtained in nine control subjects.

Results

2D histomorphometry revealed a decrease in bone volume and trabecular thickness in the bone biopsies of the CSIOP patients when compared to those of the controls. MicroCT appeared to be able to identify the reduction in thickness only when the frequency distribution of trabecular thickness was computed. No difference for the curves of the frequency distribution of trabecular separation was evidenced between patients and controls. MicroCT and 2D histomorphometric results were correlated, but 2D analysis appeared to be more sensitive. However, microCT identified a very specific thinning of the trabecular plates in their center that corresponds to the earlier stages of perforations.

Conclusion

Trabecular plate thinning can be observed and perforations occur on very thin plates in CSIOP patients.
Literatur
1.
Zurück zum Zitat Lukert BP, Raisz LG (1990) Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann Intern Med 112:352–364PubMed Lukert BP, Raisz LG (1990) Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann Intern Med 112:352–364PubMed
2.
Zurück zum Zitat Cooper C, Coupland C, Mitchell M (1995) Rheumatoid arthritis, corticosteroid therapy and hip fracture. Ann Rheum Dis 54:49–52PubMedCrossRef Cooper C, Coupland C, Mitchell M (1995) Rheumatoid arthritis, corticosteroid therapy and hip fracture. Ann Rheum Dis 54:49–52PubMedCrossRef
3.
Zurück zum Zitat van Staa TP, Leufkens HG, Abenhaim L, Zhang B, Cooper C (2000) Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. Rheumatology 39:1383–1389PubMedCrossRef van Staa TP, Leufkens HG, Abenhaim L, Zhang B, Cooper C (2000) Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. Rheumatology 39:1383–1389PubMedCrossRef
4.
Zurück zum Zitat van Staa TP, Leufkens HG, Cooper C (2002) The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777–787PubMedCrossRef van Staa TP, Leufkens HG, Cooper C (2002) The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 13:777–787PubMedCrossRef
5.
Zurück zum Zitat Hahn TJ, Halstead LR, Baran DT (1981) Effects of short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 52:111–115PubMedCrossRef Hahn TJ, Halstead LR, Baran DT (1981) Effects of short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 52:111–115PubMedCrossRef
6.
Zurück zum Zitat Braun JJ, Juttmann JR, Visser TJ, Birkenhager JC (1982) Short-term effect of prednisone on serum 1,25-dihydroxyvitamin D in normal individuals and in hyper- and hypoparathyroidism. Clin Endocrinol 17:21–28 Braun JJ, Juttmann JR, Visser TJ, Birkenhager JC (1982) Short-term effect of prednisone on serum 1,25-dihydroxyvitamin D in normal individuals and in hyper- and hypoparathyroidism. Clin Endocrinol 17:21–28
7.
Zurück zum Zitat Paz-Pacheco E, Fuleihan GE, LeBoff MS (1995) Intact parathyroid hormone levels are not elevated in glucocorticoid-treated subjects. J Bone Miner Res 10:1713–1718PubMed Paz-Pacheco E, Fuleihan GE, LeBoff MS (1995) Intact parathyroid hormone levels are not elevated in glucocorticoid-treated subjects. J Bone Miner Res 10:1713–1718PubMed
8.
Zurück zum Zitat Dalle Carbonare L, Arlot ME, Chavassieux PM, Roux JP, Portero NR, Meunier PJ (2001) Comparison of trabecular bone microarchitecture and remodeling in glucocorticoid-induced and postmenopausal osteoporosis. J Bone Miner Res 16:97–103PubMedCrossRef Dalle Carbonare L, Arlot ME, Chavassieux PM, Roux JP, Portero NR, Meunier PJ (2001) Comparison of trabecular bone microarchitecture and remodeling in glucocorticoid-induced and postmenopausal osteoporosis. J Bone Miner Res 16:97–103PubMedCrossRef
9.
Zurück zum Zitat Sasaki N, Kusano E, Ando Y, Nemoto J, Iimura O, Ito C, Takeda S, Yano K, Tsuda E, Asano Y (2002) Changes in osteoprotegerin and markers of bone metabolism during glucocorticoid treatment in patients with chronic glomerulonephritis. Bone 30:853–858PubMedCrossRef Sasaki N, Kusano E, Ando Y, Nemoto J, Iimura O, Ito C, Takeda S, Yano K, Tsuda E, Asano Y (2002) Changes in osteoprotegerin and markers of bone metabolism during glucocorticoid treatment in patients with chronic glomerulonephritis. Bone 30:853–858PubMedCrossRef
10.
Zurück zum Zitat LoCascio V, Bonucci E, Imbimbo B, Ballanti P, Adami S, Milani S, Tartarotti D, DellaRocca C (1990) Bone loss in response to long-term glucocorticoid therapy. Bone Miner 8:39–51PubMedCrossRef LoCascio V, Bonucci E, Imbimbo B, Ballanti P, Adami S, Milani S, Tartarotti D, DellaRocca C (1990) Bone loss in response to long-term glucocorticoid therapy. Bone Miner 8:39–51PubMedCrossRef
11.
Zurück zum Zitat Hall GM, Spector TD, Delmas PD (1995) Markers of bone metabolism in postmenopausal women with rheumatoid arthritis. Effects of corticosteroids and hormone replacement therapy. Arthritis Rheum 38:902–906PubMedCrossRef Hall GM, Spector TD, Delmas PD (1995) Markers of bone metabolism in postmenopausal women with rheumatoid arthritis. Effects of corticosteroids and hormone replacement therapy. Arthritis Rheum 38:902–906PubMedCrossRef
12.
Zurück zum Zitat Dolan AL, Moniz C, Dasgupta B, Li F, Mackintosh C, Todd P, Corrigall V, Panayi GS (1997) Effects of inflammation and treatment on bone turnover and bone mass in polymyalgia rheumatica. Arthritis Rheum 40:2022–2029PubMedCrossRef Dolan AL, Moniz C, Dasgupta B, Li F, Mackintosh C, Todd P, Corrigall V, Panayi GS (1997) Effects of inflammation and treatment on bone turnover and bone mass in polymyalgia rheumatica. Arthritis Rheum 40:2022–2029PubMedCrossRef
13.
Zurück zum Zitat Aaron JE, Francis RM, Peacock M, Makins NB (1989) Contrasting microanatomy of idiopathic and corticosteroid-induced osteoporosis. Clin Orthop 243:294–305 Aaron JE, Francis RM, Peacock M, Makins NB (1989) Contrasting microanatomy of idiopathic and corticosteroid-induced osteoporosis. Clin Orthop 243:294–305
14.
Zurück zum Zitat Dempster DW, Arlot MA, Meunier PJ (1983) Mean wall thickness and formation periods of trabecular bone packets in corticosteroid-induced osteoporosis. Calcif Tissue Int 35:410–417PubMedCrossRef Dempster DW, Arlot MA, Meunier PJ (1983) Mean wall thickness and formation periods of trabecular bone packets in corticosteroid-induced osteoporosis. Calcif Tissue Int 35:410–417PubMedCrossRef
15.
Zurück zum Zitat Lems WF, Gerrits MI, Jacobs JW, van Vugt RM, van Rijn HJ, Bijlsma JW (1996) Changes in (markers of) bone metabolism during high dose corticosteroid pulse treatment in patients with rheumatoid arthritis. Ann Rheum Dis 55:288–293PubMed Lems WF, Gerrits MI, Jacobs JW, van Vugt RM, van Rijn HJ, Bijlsma JW (1996) Changes in (markers of) bone metabolism during high dose corticosteroid pulse treatment in patients with rheumatoid arthritis. Ann Rheum Dis 55:288–293PubMed
16.
Zurück zum Zitat Ali NJ, Capewell S, Ward MJ (1991) Bone turnover during high dose inhaled corticosteroid treatment. Thorax 46:160–164PubMedCrossRef Ali NJ, Capewell S, Ward MJ (1991) Bone turnover during high dose inhaled corticosteroid treatment. Thorax 46:160–164PubMedCrossRef
17.
Zurück zum Zitat Chappard D, Legrand E, Baslé MF, Fromont P, Racineux JL, Rebel A, Audran M (1996) Altered trabecular architecture induced by corticosteroids: a bone histomorphometric study. J Bone Miner Res 11:676–685PubMed Chappard D, Legrand E, Baslé MF, Fromont P, Racineux JL, Rebel A, Audran M (1996) Altered trabecular architecture induced by corticosteroids: a bone histomorphometric study. J Bone Miner Res 11:676–685PubMed
18.
Zurück zum Zitat Chappard D, Legrand E, Pascaretti C, Audran M, Baslé MF (1999) Comparison of eight histomophometric methods for measuring trabecular bone architecture by image analysis on histological sections. Microsc Res Techniq 45:303–312CrossRef Chappard D, Legrand E, Pascaretti C, Audran M, Baslé MF (1999) Comparison of eight histomophometric methods for measuring trabecular bone architecture by image analysis on histological sections. Microsc Res Techniq 45:303–312CrossRef
19.
Zurück zum Zitat Parfitt AM, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ, Ott SM, Recker RR (1987) Bone histomorphometry: standardization of nomenclature, symbols, and units. Report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res 2:595–610PubMed Parfitt AM, Drezner MK, Glorieux FH, Kanis JA, Malluche H, Meunier PJ, Ott SM, Recker RR (1987) Bone histomorphometry: standardization of nomenclature, symbols, and units. Report of the ASBMR Histomorphometry Nomenclature Committee. J Bone Miner Res 2:595–610PubMed
20.
Zurück zum Zitat Parfitt AM, Matthews CHE, Villanueva AR, Kleerekoper M, Frame B, Rao DS (1983) Relationships between surface, volume and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest 72:1396–1409PubMed Parfitt AM, Matthews CHE, Villanueva AR, Kleerekoper M, Frame B, Rao DS (1983) Relationships between surface, volume and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest 72:1396–1409PubMed
21.
Zurück zum Zitat Le HM, Holmes RE, Shors E, Rosenstein DA (1992) Computerized quantitative analysis of the interconnectivity of porous biomaterials. Acta Stereol 11S1:267–272 Le HM, Holmes RE, Shors E, Rosenstein DA (1992) Computerized quantitative analysis of the interconnectivity of porous biomaterials. Acta Stereol 11S1:267–272
22.
Zurück zum Zitat Croucher PI, Garrahan NJ, Compston JE (1996) Assessment of cancellous bone structure: comparison of strut analysis, trabecular bone pattern factor, and marrow space star volume. J Bone Miner Res 11:955–961PubMed Croucher PI, Garrahan NJ, Compston JE (1996) Assessment of cancellous bone structure: comparison of strut analysis, trabecular bone pattern factor, and marrow space star volume. J Bone Miner Res 11:955–961PubMed
23.
Zurück zum Zitat Hildebrand T, Ruegsegger P (1997) A new method for the model-independent assessment of thickness in three-dimensional images. J Microsc 185:67–75CrossRef Hildebrand T, Ruegsegger P (1997) A new method for the model-independent assessment of thickness in three-dimensional images. J Microsc 185:67–75CrossRef
24.
Zurück zum Zitat Fajardo RJ, Müller R (2001) Three-dimensional analysis of nonhuman primate trabecular architecture using micro-computed tomography. Am J Phys Anthropol 115:327–336PubMedCrossRef Fajardo RJ, Müller R (2001) Three-dimensional analysis of nonhuman primate trabecular architecture using micro-computed tomography. Am J Phys Anthropol 115:327–336PubMedCrossRef
25.
Zurück zum Zitat Birkenhager-Frenkel DH, Courpron P, Hupscher EA, Clermonts E, Coutinho MF, Schmitz PI, Meunier PJ (1988) Age-related changes in cancellous bone structure. A two-dimensional study in the transiliac and iliac crest biopsy sites. Bone Miner 4:197–216PubMed Birkenhager-Frenkel DH, Courpron P, Hupscher EA, Clermonts E, Coutinho MF, Schmitz PI, Meunier PJ (1988) Age-related changes in cancellous bone structure. A two-dimensional study in the transiliac and iliac crest biopsy sites. Bone Miner 4:197–216PubMed
26.
Zurück zum Zitat Wakamatsu E, Sissons HA (1969) The cancellous bone of the iliac crest. Calcif Tissue Res 4:147–161PubMedCrossRef Wakamatsu E, Sissons HA (1969) The cancellous bone of the iliac crest. Calcif Tissue Res 4:147–161PubMedCrossRef
27.
Zurück zum Zitat Weinstein RS, Hutson MS (1987) Decreased trabecular width and increased trabecular spacing contribute to bone loss with aging. Bone 8:137–142PubMedCrossRef Weinstein RS, Hutson MS (1987) Decreased trabecular width and increased trabecular spacing contribute to bone loss with aging. Bone 8:137–142PubMedCrossRef
28.
Zurück zum Zitat Vesterby A (1993) Star volume in bone research: a histomorphometric analysis of trabecular bone structure using vertical sections. Anat Rec 235:325–334PubMedCrossRef Vesterby A (1993) Star volume in bone research: a histomorphometric analysis of trabecular bone structure using vertical sections. Anat Rec 235:325–334PubMedCrossRef
29.
Zurück zum Zitat Compston JE (1994) Connectivity of cancellous bone: Assessment and mechanical implications. Bone 15:463–466PubMedCrossRef Compston JE (1994) Connectivity of cancellous bone: Assessment and mechanical implications. Bone 15:463–466PubMedCrossRef
30.
Zurück zum Zitat Mellish RW, Ferguson-Pell MW, Cochran GV, Lindsay R, Dempster DW (1991) A new manual method for assessing two-dimensional cancellous bone structure: comparison between iliac crest and lumbar vertebra. J Bone Miner Res 6:689–696PubMedCrossRef Mellish RW, Ferguson-Pell MW, Cochran GV, Lindsay R, Dempster DW (1991) A new manual method for assessing two-dimensional cancellous bone structure: comparison between iliac crest and lumbar vertebra. J Bone Miner Res 6:689–696PubMedCrossRef
31.
Zurück zum Zitat Tabor Z, Rokita E (2002) Stochastic simulations of remodeling applied to a two-dimensional trabecular bone structure. Bone 31:413–417PubMedCrossRef Tabor Z, Rokita E (2002) Stochastic simulations of remodeling applied to a two-dimensional trabecular bone structure. Bone 31:413–417PubMedCrossRef
32.
Zurück zum Zitat Chappard D, Retailleau-Gaborit N, Legrand E, Baslé MF, Audran M (2005) Comparison insight bone measurements by histomorphometry and microCT. J Bone Miner Res 20:1177–1184PubMedCrossRef Chappard D, Retailleau-Gaborit N, Legrand E, Baslé MF, Audran M (2005) Comparison insight bone measurements by histomorphometry and microCT. J Bone Miner Res 20:1177–1184PubMedCrossRef
33.
Zurück zum Zitat Canalis E (1996) Clinical review 83: Mechanisms of glucocorticoid action in bone: implications to glucocorticoid-induced osteoporosis. J Clin Endocrinol Metab 81:3441–3447PubMedCrossRef Canalis E (1996) Clinical review 83: Mechanisms of glucocorticoid action in bone: implications to glucocorticoid-induced osteoporosis. J Clin Endocrinol Metab 81:3441–3447PubMedCrossRef
34.
Zurück zum Zitat Barbier A, Martel C, de Vernejoul MC, Tirode F, Nys M, Mocaer G, Morieux C, Murakami H, Lacheretz F (1999) The visualization and evaluation of bone architecture in the rat using three-dimensional X-ray microcomputed tomography. J Bone Miner Metab 17:37–44PubMedCrossRef Barbier A, Martel C, de Vernejoul MC, Tirode F, Nys M, Mocaer G, Morieux C, Murakami H, Lacheretz F (1999) The visualization and evaluation of bone architecture in the rat using three-dimensional X-ray microcomputed tomography. J Bone Miner Metab 17:37–44PubMedCrossRef
35.
Zurück zum Zitat Hordon LD, Itoda M, Shore PA, Shore RC, Heald M, Brown M, Kanis JA, Rodan GA, Aaron JE (2006) Preservation of thoracic spine microarchitecture by alendronate: comparison of histology and microCT. Bone 38:444–449PubMedCrossRef Hordon LD, Itoda M, Shore PA, Shore RC, Heald M, Brown M, Kanis JA, Rodan GA, Aaron JE (2006) Preservation of thoracic spine microarchitecture by alendronate: comparison of histology and microCT. Bone 38:444–449PubMedCrossRef
36.
Zurück zum Zitat Schmidt C, Priemel M, Kohler T, Weusten A, Müller R, Amling M, Eckstein F (2003) Precision and accuracy of peripheral quantitative computed tomography (pQCT) in the mouse skeleton compared with histology and microcomputed tomography (microCT). J Bone Miner Res 18:1486–1496PubMedCrossRef Schmidt C, Priemel M, Kohler T, Weusten A, Müller R, Amling M, Eckstein F (2003) Precision and accuracy of peripheral quantitative computed tomography (pQCT) in the mouse skeleton compared with histology and microcomputed tomography (microCT). J Bone Miner Res 18:1486–1496PubMedCrossRef
37.
Zurück zum Zitat Alexander JM, Bab I, Fish S, Müller R, Uchiyama T, Gronowicz G, Nahounou M, Zhao Q, White DW, Chorev M, Gazit D, Rosenblatt M (2001) Human parathyroid hormone 1–34 reverses bone loss in ovariectomized mice. J Bone Miner Res 16:1665–1673PubMedCrossRef Alexander JM, Bab I, Fish S, Müller R, Uchiyama T, Gronowicz G, Nahounou M, Zhao Q, White DW, Chorev M, Gazit D, Rosenblatt M (2001) Human parathyroid hormone 1–34 reverses bone loss in ovariectomized mice. J Bone Miner Res 16:1665–1673PubMedCrossRef
38.
Zurück zum Zitat Lane NE, Kimmel DB, Nilsson MHL, Cohen FE, Newton S, Nissenson RA, Strewler GJ (1996) Bone-selective analogs of human PTH(1–34) increase bone formation in an ovariectomized rat model. J Bone Miner Res 11:614–625PubMed Lane NE, Kimmel DB, Nilsson MHL, Cohen FE, Newton S, Nissenson RA, Strewler GJ (1996) Bone-selective analogs of human PTH(1–34) increase bone formation in an ovariectomized rat model. J Bone Miner Res 11:614–625PubMed
39.
Zurück zum Zitat Lane NE, Thompson JM, Strewler GJ, Kinney JH (1995) Intermittent treatment with human parathyroid hormone (hPTH[1–34]) increased trabecular bone volume but not connectivity in osteopenic rats. J Bone Miner Res 10:1470–1477PubMed Lane NE, Thompson JM, Strewler GJ, Kinney JH (1995) Intermittent treatment with human parathyroid hormone (hPTH[1–34]) increased trabecular bone volume but not connectivity in osteopenic rats. J Bone Miner Res 10:1470–1477PubMed
40.
Zurück zum Zitat Weinstein RS, Manolagas SC (2005) Apoptosis in glucocorticosteroid-induced bone disease. Curr Opin Endocrinol Diabetes 12:219–223CrossRef Weinstein RS, Manolagas SC (2005) Apoptosis in glucocorticosteroid-induced bone disease. Curr Opin Endocrinol Diabetes 12:219–223CrossRef
Metadaten
Titel
Bone microarchitecture in males with corticosteroid-induced osteoporosis
verfasst von
D. Chappard
N. Josselin
C. Rougé-Maillart
E. Legrand
M. F. Baslé
M. Audran
Publikationsdatum
01.04.2007
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 4/2007
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0278-8

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