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Altered bone composition in children with vertebral fracture
Authors:Inari S Tamminen  Mervi K Mäyränpää  Mikael J Turunen  Hanna Isaksson  Outi Mäkitie  Jukka S Jurvelin  Heikki Kröger
Affiliation:1. Bone and Cartilage Research Unit, University of Eastern Finland, Kuopio, Finland;2. Department of Applied Physics, University of Eastern Finland, Kuopio, Finland;3. Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland;4. Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland;5. Department of Clinical Physiology, University of Eastern Finland, Kuopio, Finland;6. Department of Pediatrics, Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
Abstract:Primary osteoporosis in children often leads to vertebral fractures, but it remains unknown whether these fractures associate with changes in bone composition. This study aimed to determine the differences in bone composition in fracture‐prone children with and without vertebral fractures, as assessed by Fourier transform infrared spectroscopic imaging (FTIRI) and bone histomorphometry. Iliac crest bone biopsies (n = 24) were obtained from children who were suspected of primary osteoporosis based on evidence from the fracture history and/or low bone mineral density (BMD) by dual‐energy X‐ray absorptiometry. Vertebral morphology was determined by radiography. Bone biopsies were analyzed using histomorphometry and FTIRI. Phosphate‐to‐amide I, carbonate‐to‐phosphate, carbonate‐to‐amide I, and cross‐link ratio (collagen maturity) were calculated. Children with (n = 14) and without (n = 10) vertebral fracture were compared. Low cancellous bone volume (BV/TV) was detected by histomorphometry in 36% of the children with vertebral fracture, and bone turnover rate was abnormal in 64% of them. Children with vertebral fractures had lower carbonate‐to‐phosphate ratios (p < .05) and higher collagen maturity (p < .05) than children without vertebral fracture. The children with low BV/TV in biopsy showed lower carbonate‐to‐amide I ratios (p < .05) than the children with normal bone volume. This study showed changes in bone composition among fracture‐prone children who had sustained a vertebral fracture. The observed changes in bone composition in these children may contribute to their greater propensity to sustain vertebral fractures. © 2011 American Society for Bone and Mineral Research
Keywords:FTIRI  BONE HISTOMORPHOMETRY  TRABECULAR BONE  ILIAC CREST
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