Year: 2006
Type: article
Abstract: We agree with Chavassieux and Delmas that patients with osteoporosis have considerable heterogeneity of remodeling—a point we stressed in our paper. We also note that our paper(1) was the first histologically based demonstration both of the change in remodeling activity across menopause and the further increase over the ensuing 10–15 years. The fact that the biomarker data cited by Chavassieux and Delmas do not capture this latter increase is caused by the differential sensitivity of histomorphometry and biomarkers with respect to the effect of wall thickness. Chavassieux and Delmas note the critical dependence of activation frequency (Ac.f) on this measure but apparently fail to recognize its importance for fragility. The histomorphometric measurements are precisely surface‐based, whereas the biomarker data are, necessarily, volume‐based. However, fragility, like politics, is local. Surface‐located remodeling sites are the causes of considerable fragility, and hence measuring the increased numbers of remodeling sites (which cannot be captured by total body biomarker measurements) precisely captures the increase in local fragility.
DOI: 10.1359/jbmr.051012
Institution: Creighton University
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2089550920