{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:30:56Z","timestamp":1792845056066,"version":"4.5.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2004,12,1]],"date-time":"2004-12-01T00:00:00Z","timestamp":1101859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In a population-based, cross-sectional study, we assessed age- and sex-specific changes in bone structure by QCT. Over life, the cross-sectional area of the vertebrae and proximal femur increased by \u223c15% in both sexes, whereas vBMD at these sites decreased by 39\u201355% and 34\u201346%, respectively, with greater decreases in women than in men.<\/jats:p>\n                  <jats:p>Introduction: The changes in bone structure and density with aging that lead to fragility fractures are still unclear.<\/jats:p>\n                  <jats:p>Materials and Methods: In an age- and sex-stratified population sample of 373 women and 323 men (age, 20\u201397 years), we assessed bone geometry and volumetric BMD (vBMD) by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia.<\/jats:p>\n                  <jats:p>Results: In young adulthood, men had 35\u201342% larger bone areas than women (p &amp;lt; 0.001), consistent with their larger body size. Bone area increased equally over life in both sexes by \u223c15% (p &amp;lt; 0.001) at central sites and by \u223c16% and slightly more in men at peripheral sites. Decreases in trabecular vBMD began before midlife and continued throughout life (p &amp;lt; 0.001), whereas cortical vBMD decreases began in midlife. Average decreases in trabecular vBMD were greater in women (\u221255%) than in men (\u221246%, p &amp;lt; 0.001) at central sites, but were similar (\u221224% and \u221226%, respectively) at peripheral sites. With aging, cortical area decreased slightly, and the cortex was displaced outwardly by periosteal and endocortical bone remodeling. Cortical vBMD decreased over life more in women (\u223c25%) than in men (\u223c18%, p &amp;lt; 0.001), consistent with menopausal-induced increases in bone turnover and bone porosity.<\/jats:p>\n                  <jats:p>Conclusions: Age-related changes in bone are complex. Some are beneficial to bone strength, such as periosteal apposition with outward cortical displacement. Others are deleterious, such as increased subendocortical resorption, increased cortical porosity, and, especially, large decreases in trabecular vBMD that may be the most important cause of increased skeletal fragility in the elderly. Our findings further suggest that the greater age-related decreases in trabecular and cortical vBMD and perhaps also their smaller bone size may explain, in large part, why fragility fractures are more common in elderly women than in elderly men.<\/jats:p>","DOI":"10.1359\/jbmr.040916","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T02:05:46Z","timestamp":1146103546000},"page":"1945-1954","source":"Crossref","is-referenced-by-count":811,"title":["Population-Based Study of Age and Sex Differences in Bone Volumetric Density, Size, Geometry, and Structure at Different Skeletal Sites"],"prefix":"10.1093","volume":"19","author":[{"given":"B Lawrence","family":"Riggs","sequence":"first","affiliation":[{"name":"Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"L Joseph","family":"Melton","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A","family":"Robb","sequence":"additional","affiliation":[{"name":"Biomedical Imaging Resource, Department of Physiology and Biophysics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon J","family":"Camp","sequence":"additional","affiliation":[{"name":"Biomedical Imaging Resource, Department of Physiology and Biophysics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M","family":"Peterson","sequence":"additional","affiliation":[{"name":"Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy A","family":"Rouleau","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia H","family":"McCollough","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L","family":"Bouxsein","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundeep","family":"Khosla","sequence":"additional","affiliation":[{"name":"Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,2]]},"reference":[{"key":"2024013019183935500_bib1","first-page":"1","article-title":"Osteoporosis prevention, diagnosis, and therapy","volume":"17","author":"Anonymous","year":"2000","journal-title":"NIH Consens State Sci Statements"},{"key":"2024013019183935500_bib2","doi-asserted-by":"crossref","first-page":"49S","DOI":"10.1016\/0002-9343(91)90248-V","article-title":"Measurement of bone mineral density: Current status","volume":"91","author":"Genant","year":"1991","journal-title":"Am J Med"},{"key":"2024013019183935500_bib3","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1359\/jbmr.1997.12.4.509","article-title":"From density to structure: Growing up and growing old on the surfaces of bone","volume":"12","author":"Seeman","year":"1997","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib4","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/jbmr.5650070204","article-title":"New approaches for interpreting projected bone densitometry data","volume":"7","author":"Carter","year":"1992","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib5","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/B978-012470862-4\/50020-9","volume-title":"Osteoporosis","author":"Bouxsein","year":"2001","edition":"2nd ed."},{"key":"2024013019183935500_bib6","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/00004424-199001000-00004","article-title":"Predicting femoral neck strength from bone mineral data: A structural approach","volume":"25","author":"Beck","year":"1990","journal-title":"Invest Radiol"},{"key":"2024013019183935500_bib7","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1359\/jbmr.2000.15.12.2297","article-title":"Structural trends in the aging femoral neck and proximal shaft: Analysis of the third national health and nutrition examination survey dual-energy X-ray absorptiometry data","volume":"15","author":"Beck","year":"2000","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib8","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1359\/jbmr.2003.18.10.1766","article-title":"Structural and biomechanical basis of sexual dimorphism in femoral neck fragility has its origins in growth and aging","volume":"18","author":"Duan","year":"2003","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib9","article-title":"Contributions of bone density and structure to fracture risk assessment in men and women","author":"Melton","year":"2004","journal-title":"Osteoporos Int"},{"key":"2024013019183935500_bib10","first-page":"225","volume-title":"Osteoporosis: Etiology, Diagnosis, and Management","author":"Melton","year":"1995"},{"key":"2024013019183935500_bib11","doi-asserted-by":"crossref","first-page":"266","DOI":"10.4065\/71.3.266","article-title":"History of the Rochester Epidemiology Project","volume":"71","author":"Melton","year":"1996","journal-title":"Mayo Clin Proc"},{"key":"2024013019183935500_bib12","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1148\/radiology.166.2.3275985","article-title":"Quantitative CT for determination of bone mineral density: A review","volume":"166","author":"Cann","year":"1988","journal-title":"Radiology"},{"key":"2024013019183935500_bib13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/0720-048X(95)00631-Y","article-title":"The European Spine Phantom\u2014a tool for standardiztion and quality control in spinal bone mineral measurements by DXA and QCT","volume":"20","author":"Kalender","year":"1995","journal-title":"Eur J Radiol"},{"key":"2024013019183935500_bib14","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1117\/12.535745","article-title":"A system for the analysis of whole-bone strength from helical CT images","volume":"5369","author":"Camp","year":"2004","journal-title":"Proc SPIE"},{"key":"2024013019183935500_bib15","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/00019616-199405000-00004","article-title":"The use of peripheral QCT in the evaluation of bone remodeling","volume":"4","author":"Ruegsegger","year":"1994","journal-title":"Endocrinologist"},{"key":"2024013019183935500_bib16","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4899-2819-1","volume-title":"Modern Applied Statistics with S-Plus","author":"Venables","year":"1994"},{"key":"2024013019183935500_bib17","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/00004728-199901000-00027","article-title":"Assessment of vertebral bone mineral density using volumetric quantitative CT","volume":"23","author":"Lang","year":"1999","journal-title":"J Comput Assist Tomogr"},{"key":"2024013019183935500_bib18","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1097\/00004424-199307000-00003","article-title":"The relationship of trabecular and cortical bone mineral density to spinal fractures","volume":"28","author":"Ito","year":"1993","journal-title":"Invest Radiol"},{"key":"2024013019183935500_bib19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/8756-3282(91)90007-6","article-title":"Differential effects of aging and disease on trabecular and compact bone density of the radius","volume":"12","author":"Ruegsegger","year":"1991","journal-title":"Bone"},{"key":"2024013019183935500_bib20","doi-asserted-by":"crossref","first-page":"605","DOI":"10.7326\/0003-4819-101-5-605","article-title":"Marked disparity between trabecular and cortical bone loss with age in healthy men","volume":"101","author":"Meier","year":"1984","journal-title":"Ann Intern Med"},{"key":"2024013019183935500_bib21","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s002239900601","article-title":"Bone density reduction in various measurement sites in men and women with osteoporotic fractures of spine and hip: The European Quantitation of Osteoporosis Study","volume":"64","author":"Kroger","year":"1999","journal-title":"Calcif Tissue Int"},{"key":"2024013019183935500_bib22","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s001980050133","article-title":"Normal changes in spinal bone mineral density in a Chinese population: Assessment by quantitative computed tomography and dual-energy X-ray absorptiometry","volume":"9","author":"Yu","year":"1999","journal-title":"Osteoporos Int"},{"key":"2024013019183935500_bib23","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/BF02678144","article-title":"A comparison of spinal quantitative computed tomography with dual energy x-ray absorptiometry in European women with vertebral and nonvertebral fractures","volume":"68","author":"Bergot","year":"2001","journal-title":"Calcif Tissue Int"},{"key":"2024013019183935500_bib24","first-page":"75","article-title":"Reference values for trabecular and cortical vertebral bone density in single and dual-energy quantitative computed tomography","volume":"9","author":"Kalender","year":"1989","journal-title":"Eur J Radiol"},{"key":"2024013019183935500_bib25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1118\/1.1521940","article-title":"Accuracy of CT-based thickness measurement of thin structures: Modeling of limited spatial resolution in all three dimensions","volume":"30","author":"Prevrhal","year":"2003","journal-title":"Med Phys"},{"key":"2024013019183935500_bib26","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s003300050972","article-title":"Age-related changes assessed by peripheral QCT in healthy Italian women","volume":"10","author":"Guglielmi","year":"2000","journal-title":"Eur Radiol"},{"key":"2024013019183935500_bib27","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1148\/radiology.190.3.8115609","article-title":"Gender differences in vertebral body sizes in children and adolescents","volume":"190","author":"Gilsanz","year":"1994","journal-title":"Radiology"},{"key":"2024013019183935500_bib28","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1172\/JCI111096","article-title":"Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis","volume":"72","author":"Parfitt","year":"1983","journal-title":"J Clin Invest"},{"key":"2024013019183935500_bib29","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/8756-3282(95)80027-N","article-title":"Temporal changes in cancellous bone structure immediately after ovariectomy","volume":"16","author":"Dempster","year":"1995","journal-title":"Bone"},{"key":"2024013019183935500_bib30","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/S0140-6736(76)92217-0","article-title":"Long-term prevention of postmenopausal osteoporosis by oestrogen","volume":"1","author":"Lindsay","year":"1976","journal-title":"Lancet"},{"key":"2024013019183935500_bib31","first-page":"210","article-title":"Age changes in human bone","volume":"17","author":"Jowsey","year":"1960","journal-title":"Clin Orthop"},{"key":"2024013019183935500_bib32","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1002\/jbmr.5650091003","article-title":"The bone-remodeling transient: Implications for the interpretation of clinical studies of bone mass change","volume":"9","author":"Heaney","year":"1994","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib33","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1002\/jbmr.5650110203","article-title":"A new model for the regulation of bone resorption, with particular reference to the effects of bisphosphonates","volume":"11","author":"Parfitt","year":"1996","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib34","doi-asserted-by":"crossref","first-page":"699","DOI":"10.7326\/0003-4819-97-5-699","article-title":"Quantitative computed tomography of vertebral spongiosa: A sensitive method for detecting early bone loss after oophorectomy","volume":"97","author":"Genant","year":"1982","journal-title":"Ann Intern Med"},{"key":"2024013019183935500_bib35","doi-asserted-by":"crossref","first-page":"2276","DOI":"10.1359\/jbmr.2001.16.12.2276","article-title":"The biomechanical basis of vertebral body fragility in men and women","volume":"16","author":"Duan","year":"2001","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib36","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1002\/jor.1100060613","article-title":"Sex differences in age-related remodeling of the femur and tibia","volume":"6","author":"Ruff","year":"1988","journal-title":"J Orthop Res"},{"key":"2024013019183935500_bib37","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00198-002-1322-y","article-title":"Aging bone in men and women: Beyond changes in bone mineral density","volume":"14","author":"Russo","year":"2003","journal-title":"Osteoporos Int"},{"key":"2024013019183935500_bib38","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s002239900193","article-title":"Age-related cortical bone loss at the metacarpal","volume":"60","author":"Maggio","year":"1997","journal-title":"Calcif Tissue Int"},{"key":"2024013019183935500_bib39","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0030-5898(20)30477-6","article-title":"The course of bone gain and the phases of bone loss","volume":"3","author":"Garn","year":"1972","journal-title":"Orthop Clin North Am"},{"key":"2024013019183935500_bib40","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1172\/JCI112462","article-title":"Rates of bone loss in the appendicular and axial skeletons of women: Evidence of substantial vertebral bone loss before menopause","volume":"77","author":"Riggs","year":"1986","journal-title":"J Clin Invest"},{"key":"2024013019183935500_bib41","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1210\/edrv.23.3.0465","article-title":"Sex steroids and the construction and conservation of the adult skeleton","volume":"23","author":"Riggs","year":"2002","journal-title":"Endocr Rev"},{"key":"2024013019183935500_bib42","first-page":"2266","article-title":"Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: A key role for bioavailable estrogen","volume":"83","author":"Khosla","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2024013019183935500_bib43","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1210\/jcem.87.4.8417","article-title":"Estrogen and the male skeleton","volume":"87","author":"Khosla","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2024013019183935500_bib44","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1056\/NEJM199011013231801","article-title":"Spinal bone loss and ovulatory disturbances","volume":"323","author":"Prior","year":"1990","journal-title":"N Engl J Med"},{"key":"2024013019183935500_bib45","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1172\/JCI118382","article-title":"Sex steroids, bone mass and bone loss. A prospective study of pre-, peri-, and postmenopausal women","volume":"97","author":"Slemenda","year":"1996","journal-title":"J Clin Invest"},{"key":"2024013019183935500_bib46","doi-asserted-by":"crossref","first-page":"5327","DOI":"10.1210\/jc.2003-030736","article-title":"Longitudinal association between sex hormone levels, bone loss, and bone turnover in elderly men","volume":"88","author":"Gennari","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"2024013019183935500_bib47","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1359\/jbmr.2000.15.1.24","article-title":"Determinants of bone loss from the femoral neck in women of different ages","volume":"15","author":"Melton","year":"2000","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib48","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1097\/00004728-198911000-00015","article-title":"Impact of marrow fat on accuracy of quantitative CT","volume":"13","author":"Gluer","year":"1989","journal-title":"J Comput Assist Tomogr"},{"key":"2024013019183935500_bib49","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1002\/jbmr.5650050515","article-title":"Lateral dual-photon absorptiometry: A new technique to measure the bone mineral density at the lumbar spine","volume":"5","author":"Uebelhart","year":"1990","journal-title":"J Bone Miner Res"},{"key":"2024013019183935500_bib50","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1159\/000143440","article-title":"Quantitative structural analysis of human cancellous bone","volume":"75","author":"Merz","year":"1970","journal-title":"Acta Anat"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1359%2Fjbmr.040916","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/19\/12\/1945\/56475223\/5650191203.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/19\/12\/1945\/56475223\/5650191203.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T11:07:33Z","timestamp":1710328053000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/19\/12\/1945-1954\/7592840"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,12,1]]},"references-count":50,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2009,12,2]]},"published-print":{"date-parts":[[2004,12,1]]}},"URL":"https:\/\/doi.org\/10.1359\/jbmr.040916","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,12,1]]},"published":{"date-parts":[[2004,12,1]]}}}