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Techniques and Methods

Improved femoral micro-architecture in adult male individuals with overweight: fracture resistance due to regional specificities

Abstract

Background

It is still unclear whether femoral fracture risk is positively or negatively altered in individuals with overweight. Considering the lack of studies including men with overweight, this study aimed to analyze regional specificities in mechano-structural femoral properties (femoral neck and intertrochanteric region) in adult male cadavers with overweight compared to their normal-weight age-matched counterparts.

Methods

Ex-vivo osteodensitometry, micro-computed tomography, and Vickers micro-indentation testing were performed on femoral samples taken from 30 adult male cadavers, divided into the group with overweight (BMI between 25 and 30 kg/m2; n = 14; age:55 ± 16 years) and control group (BMI between 18.5 and 25 kg/m2; n = 16; age:51 ± 18 years).

Results

Better quality of trabecular and cortical microstructure in the inferomedial (higher trabecular bone volume fraction, trabecular thickness, and cortical thickness, coupled with reduced cortical pore diameter, p < 0.05) and superolateral femoral neck (higher trabecular number and tendency to lower cortical porosity, p = 0.043, p = 0.053, respectively) was noted in men with overweight compared to controls. Additionally, the intertrochanteric region of men with overweight had more numerous and denser trabeculae, coupled with a thicker and less porous cortex (p < 0.05). Still, substantial overweight-induced change in femoral osteodensitometry parameters and Vickers micro-hardness was not demonstrated in assessed femoral subregions (p > 0.05).

Conclusions

Despite the absence of significant changes in femoral osteodensitometry, individuals with overweight had better trabecular and cortical femoral micro-architecture implying higher femoral fracture resistance. However, the microhardness was not significantly favorable in the individuals who were overweight, indicating the necessity for further research.

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Fig. 1: The methodological steps used to assess femoral mechano-structure in individuals with overweight.
Fig. 2: The comparison of the representative femoral micro-architectural parameters between individuals with overweight and their age-matched normal-weight counterparts.
Fig. 3: The region-specific percentage of the difference between the group with overweight and control group in representative micro-architectural parameters.

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Data availability

Data generated during this study are available from the corresponding author (MD) upon justified request.

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Acknowledgements

This study received financial support from the Science Fund of the Republic of Serbia (IDEAS program, grant no. 7749444, BoFraM project) and the Ministry of Science of the Republic of Serbia (grant no. 200110 and 451–03–1524/2023–04/18). The Authors thank Dr. Miomira Ivovic for her valuable help during DXA scanning.

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Authors and Affiliations

Authors

Contributions

JJ, PM and MD conceptualized the study and used methodology. VZ and SN carried out sample collection. JJ and UA conducted data acquisition and wrote the original draft. All authors interpreted the results and provided review and editing of the manuscript. MD was responsible for project administration and funding acquisition. All authors approved the submitted version of the manuscript.

Corresponding author

Correspondence to Marija Djuric.

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Competing interests

The authors declare no competing interests.

Ethics approval

The Ethics Committee of the Faculty of Medicine, University of Belgrade confirmed that our study complied with relevant national and international standards based on the Declaration of Helsinki principles (approval no. 1322/VII-17). The Institutional Ethics Committee waived the informed consent requirement for collecting the samples included in the study.

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Jadzic, J., Andjelic, U., Milovanovic, P. et al. Improved femoral micro-architecture in adult male individuals with overweight: fracture resistance due to regional specificities. Int J Obes 48, 202–208 (2024). https://doi.org/10.1038/s41366-023-01389-z

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