Accelerated Bone Loss in Older Men: Effects on Bone Microarchitecture and Strength

ABSTRACT Accelerated bone loss (ABL) shown on routine dual‐energy X‐ray absorptiometry (DXA) may be accompanied by microarchitectural changes, increased cortical porosity, and lower bone strength. To test this hypothesis, we performed a cross‐sectional study and used high‐resolution peripheral quantitative computed tomography (HR‐pQCT) scans (Scanco Medical AG, Brüttisellen, Switzerland) to measure estimated bone strength and microarchitecture in the distal radius and distal and diaphyseal tibia. We studied 1628 men who attended the year 14 exam of the Osteoporotic Fractures in Men (MrOS) study. We retrospectively characterized areal bone mineral density (aBMD) change from the year 7 to year 14 exam in three categories: “accelerated” loss, ≥10% loss at either the total hip or femoral neck (n = 299, 18.4%); “expected” loss,