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Reexamining the Surfaces of Bone in Boys and Girls During Adolescent Growth: A 12‐Year Mixed Longitudinal pQCT Study
Author(s) -
Gabel Leigh,
Nettlefold Lindsay,
Brasher Penelope M,
Moore Sarah A,
Ahamed Yasmin,
Macdonald Heather M,
McKay Heather A
Publication year - 2015
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.2570
Subject(s) - medicine , quantitative computed tomography , medullary cavity , apposition , confidence interval , bone mineral , nuclear medicine , cortical bone , urology , osteoporosis , anatomy
ABSTRACT We revisit Stanley Garn's theory related to sex differences in endocortical and periosteal apposition during adolescence using a 12‐year mixed longitudinal study design. We used peripheral quantitative computed tomography to examine bone parameters in 230 participants (110 boys, 120 girls; aged 11.0 years at baseline). We assessed total (Tt.Ar, mm 2 ), cortical (Ct.Ar, mm 2 ), and medullary canal area (Me.Ar, mm 2 ), Ct.Ar/Tt.Ar, cortical bone mineral density (Ct.BMD, mg/cm 3 ), and polar strength‐strain index (SSI p , mm 3 ) at the tibial midshaft (50% site). We used annual measures of height and chronological age to identify age at peak height velocity (APHV) for each participant. We compared annual accrual rates of bone parameters between boys and girls, aligned on APHV using a linear mixed effects model. At APHV, boys demonstrated greater Tt.Ar (ratio = 1.27; 95% confidence interval [CI] 1.21, 1.32), Ct.Ar (1.24 [1.18, 1.30]), Me.Ar (1.31 [1.22, 1.40]), and SSI p (1.36 [1.28, 1.45]) and less Ct.Ar/Tt.Ar (0.98 [0.96, 1.00]) and Ct.BMD (0.97 [0.96, 0.97]) compared with girls. Boys and girls demonstrated periosteal bone formation and net bone loss at the endocortical surface. Compared with girls, boys demonstrated greater annual accrual rates pre‐APHV for Tt.Ar (1.18 [1.02, 1.34]) and Me.Ar (1.34 [1.11, 1.57]), lower annual accrual rates pre‐APHV for Ct.Ar/Tt.Ar (0.56 [0.29, 0.83]) and Ct.BMD (–0.07 [–0.17, 0.04]), and similar annual accrual rates pre‐APHV for Ct.Ar (1.10 [0.94, 1.26]) and SSI p (1.14 [0.98, 1.30]). Post‐APHV, boys demonstrated similar annual accrual rates for Ct.Ar/Tt.Ar (1.01 [0.71, 1.31]) and greater annual accrual rates for all other bone parameters compared with girls (ratio = 1.23 to 2.63; 95% CI 1.11 to 3.45). Our findings support those of Garn and others of accelerated periosteal apposition during adolescence, more evident in boys than girls. However, our findings challenge the notion of greater endocortical apposition in girls, suggesting instead that girls experience diminished endocortical resorption compared with boys. © 2015 American Society for Bone and Mineral Research.