Work

Sex-specific skeletal aging trajectories and reference centiles across vertebrae and ribs in over 78,000 patients

Year: 2026

Type: preprint

Abstract: Skeletal aging is usually assessed at one site, so how bone loss differs across the skeleton and between sexes is unclear. We analyzed non-contrast torso CT from 2024 in 78,620 patients aged 15–100 years (41,056 men, 37,564 women) at nine Japanese hospitals, measuring mean attenuation of 25 vertebrae and 24 ribs from TotalSegmentator masks. We fitted sex-specific mean curves and quantile-regression centiles, and assessed each site as an L1 surrogate by age-adjusted correlation, errors-in-variables conversion and discrimination of low-for-age L1. Attenuation fell with age at all 49 sites in women and 46 of 49 in men, with a sex-dependent shape everywhere (all FDR-adjusted P < 0.0001). Female decline was steepest at a median of 52.0 years. L2 reproduced L1 closely (limits of agreement ±45–46 HU); ribs did not (±68 to ±82 HU). These centiles place an automated measurement at any of 49 sites against age- and sex-matched peers.

Source: medRxiv

DOI: 10.64898/2026.10.30.26363202

Authors: Yosuke Yamagishi, Tomohiro Kikuchi, Kohei Yamamoto, Shouhei Hanaoka, Takeharu Yoshikawa, Osamu Abe

Institutions: The University of Tokyo, Jichi Medical University, University of Tokyo Hospital

Language: English

Topic: Bone health and osteoporosis research

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green