Age and sex differences in tibia morphology in healthy adult Caucasians

Abstract Variability in peripheral Quantitative Computed Tomography (pQCT) measurement sites limits direct comparisons of results between studies. Further, it is unclear what estimates of bone strength are most indicative of changes due to aging, disease, or interventions. The purpose of this study was to examine age group and sex differences in tibia morphology. Additional purposes of this study were to determine which tibia site or sites are most sensitive for detecting age and sex differences. Methods Self-identifying Caucasian men (n = 55) and women (n = 59) ages 20–59 years and separated by decades had their non-dominant tibias measured with pQCT (Stratec XCT 3000) at every 10% of the limb length from 5% to 85% (distal to proximal). Volumetric BMD and BMC of the total, cortical and trabecular bone were determined, as well as periosteal (PeriC) and endosteal (EndoC) circumferences, and cortical thickness (CTh). Results There were significant (p < 0.01) site effects for all BMC, vBMD, PeriC and EndoC measures. Large sex differences (men > women) in Tot.BMC (21–28%) were paralleled by differences in Cort.BMC (21–25%) (p < 0.01). Site ∗ sex interaction effects were significant (p < 0.05) for BMC (peak sex difference: 5%, 15%, 25%, 85% sites) and circumference (peak sex difference: 65% site) variables. CTh and total vBMD were lowest (p < 0.05) in 50–59 year group, and EndoC was highest in the 50–59 year group. Site ∗ age interactions existed for Cort.vBMD, Tot.BMC (85% site), and EndoC (25%, 35%, 55%–85% sites). Correcting for bone free lean body mass (BFLBM) greatly reduced sex differences, eliminating sex ∗ site interaction effects, but sex main effects remained significant. Correcting for BFLBM did not eliminate age effects. Conclusion The magnitude of age and sex differences in tibia variables varied by measurement site demonstrating the need for standardization of measurement sites.