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Thomas M. Link - One of the best experts on this subject based on the ideXlab platform.
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Imaging of Diabetic Bone Structure
Diabetic Bone Disease, 2016Co-Authors: Thomas M. Link, Ursula HeilmeierAbstract:Epidemiological studies have found that patients with type 2 diabetes mellitus (T2DM) have a higher incidence of fragility fractures despite normal or elevated Bone mineral density (BMD) measured with DXA. Studies have shown that Bone Structure and composition independent of BMD may explain the increased risk of fragility fractures in T2DM. High-resolution quantitative computed tomography (HR-pQCT) is a new technology to investigate Bone quality analyzing cortical and trabecular Bone Structure. Using HR-pQCT differences in cortical porosity at the distal radius and tibia between T2DM patients with and without fragility fractures have been found. It has been suggested that cortical porosity may serve as a new imaging biomarker for increased fragility in T2DM. In addition, abnormalities of Bone marrow fat using MR spectroscopy of the spine were demonstrated in T2DM patients: vertebral Bone marrow fat content correlated significantly with HbA1c and visceral adipose tissue in T2DM patients and decreased unsaturated Bone marrow lipids were found to be associated with T2DM and fragility fractures. Other imaging technologies that have been used to assess Bone Structure and texture in diabetic Bone disease are high-resolution MRI, quantitative ultrasound, and trabecular Bone score derived from DXA images. This chapter will summarize results from recent studies analyzing Bone Structure and quality in patients with diabetic Bone disease and increased fracture risk.
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Trabecular Bone Structure analysis of the spine using clinical MDCT: can it predict vertebral Bone strength?
Journal of bone and mineral metabolism, 2013Co-Authors: Thomas Baum, Thomas M. Link, Martin Gräbeldinger, C. Räth, Eduardo Grande Garcia, Rainer Burgkart, Janina M. Patsch, Ernst J. Rummeny, Jan S. BauerAbstract:Recent technical improvements have made it possible to determine trabecular Bone Structure parameters of the spine using clinical multi-detector computed tomography (MDCT). Therefore, the purpose of this study was to analyze trabecular Bone Structure parameters obtained from clinical MDCT in relation to high resolution peripheral quantitative computed tomography (HR-pQCT) as a standard of reference and to investigate whether clinical MDCT can predict vertebral Bone strength. Fourteen functional spinal segment units between T7 and L3 were harvested from 14 formalin-fixed human cadavers (11 women and 3 men; age 84 ± 10 years). All functional spinal segment units were examined using HR-pQCT (isotropic voxel size of 41 μm3) and a clinical whole-body MDCT (interpolated voxel size of 146 × 146 × 300 μm3). Trabecular Bone Structure analyses (histomorphometric and texture measures) were performed in the HR-pQCT as well as MDCT images. Vertebral failure load (FL) of the functional spinal segment units was determined in an uniaxial biomechanical test. The HR-pQCT and MDCT derived trabecular Bone Structure parameters showed correlations ranging from r = 0.60 to r = 0.90 (p 0.05). In this cadaver model, the spatial resolution of clinically available whole-body MDCT scanners was suitable for trabecular Bone Structure analysis of the spine and to predict vertebral Bone strength.
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Reproducibility of trabecular Bone Structure measurements of the distal radius at 1.5 and 3.0 T magnetic resonance imaging
Journal of computer assisted tomography, 2012Co-Authors: Thomas Baum, Thomas M. Link, C. Räth, Ernst J. Rummeny, Yvonne Dütsch, Dirk K. Müller, Roberto A. Monetti, Irina Sidorenko, Jan S. BauerAbstract:The purpose of this study was to assess and compare the reproducibility of trabecular Bone Structure measurements of the distal radius at 1.5 and 3.0 T magnetic resonance imaging (MRI). Root mean square reproducibility errors ranged from 0.69% to 4.94% at 1.5 T MRI and from 0.38% to 5.80% at 3.0 T MRI. Thus, reproducibility errors of trabecular Bone Structure measurements are overall in an acceptable range and similar at 1.5 and 3.0 T MRI.
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Screening: Assessing Bone Structure in the prediction of osteoporotic fractures.
Nature reviews. Rheumatology, 2011Co-Authors: Thomas M. LinkAbstract:Measuring Bone Structure could improve prediction of Bone strength, but the clinical feasibility of available imaging technologies is limited. The trabecular Bone score—a dual-energy X-ray absorptiometry texture algorithm—has shown promise in fracture prediction in a large cohort study, and might provide a practical means of assessing Bone quality.
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assessment of trabecular Bone Structure of the calcaneus using multi detector ct correlation with microct and biomechanical testing
Bone, 2009Co-Authors: Thomas M. Link, Sharmila Majumdar, Andrew J. Burghardt, Gerd Diederichs, Marie Kentenich, Karsten Schwieger, Markus B Huber, Patrik RogallaAbstract:Abstract The prediction of Bone strength can be improved when determining Bone mineral density (BMD) in combination with measures of trabecular microarchitecture. The goal of this study was to assess parameters of trabecular Bone Structure and texture of the calcaneus by clinical multi-detector row computed tomography (MDCT) in an experimental in situ setup and to correlate these parameters with microCT (μCT) and biomechanical testing. Thirty calcanei in 15 intact cadavers were scanned using three different protocols on a 64-slice MDCT scanner with an in-plane pixel size of 208 μm and 500 μm slice thickness. Bone cores were harvested from each specimen and μCT images with a voxel size of 16 μm were obtained. After image coregistration, trabecular Bone Structure and texture were evaluated in identical regions on the MDCT images. After data acquisition, uniaxial compression testing was performed. Significant correlations between MDCT- and μCT-derived measures of Bone volume fraction (BV/TV), trabecular thickness (Tb.Th) and trabecular separation (Tb.Sp) were found (range, R 2 = 0.19–0.65, p p p
H K Genant - One of the best experts on this subject based on the ideXlab platform.
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three quantitative ultrasound parameters reflect Bone Structure
Calcified Tissue International, 1994Co-Authors: Clausc Gluer, M Jergas, Steven A Goldstein, H K GenantAbstract:We investigated whether quantitative ultrasound (QUS) parameters are associated with Bone Structure. In an in vitro study on 20 cubes of trabecular Bone, we measured broadband ultrasound attenuation (BUA) and two newly defined parameters—ultrasound velocity through Bone (UVB) and ultrasound attenuation in Bone (UAB). Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA) and Bone Structure was assessed by microcomputed tomography (μCT) with approximately 80 μm spatial resolution. We found all three QUS parameters to be significantly associated with Bone Structure independently of BMD. UVB was largely influenced by trabecular separation, UAB by connectivity, and BUA by a combination of both. For a one standard deviation (SD) increase in UVB, a decrease in trabecular separation of 1.2 SD was required compared with a 1.4 SD increase in BMD for the same effect. A 1.0 SD increase in UAB required a reduction in connectivity of 1.4 SD. Multivariate models of QUS versus BMD combined with Bone Structure parameters showed squared correlation coefficients of r2=0.70–0.85 for UVB, r2=0.27–0.56 for UAB, and r2=0.30–0.68 for BUA compared with r2=0.18–0.58 for UVB, r2<0.26 for UAB and r2<0.13 for BUA for models including BMD alone. QUS thus reflects Bone Structure, and a combined analysis of QUS and BMD will allow for a more comprehensive assessment of skeletal status than either method alone.
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Three quantitative ultrasound parameters reflect Bone Structure
Calcified tissue international, 1994Co-Authors: Clausc Gluer, M Jergas, Steven A Goldstein, H K GenantAbstract:We investigated whether quantitative ultrasound (QUS) parameters are associated with Bone Structure. In an in vitro study on 20 cubes of trabecular Bone, we measured broadband ultrasound attenuation (BUA) and two newly defined parameters—ultrasound velocity through Bone (UVB) and ultrasound attenuation in Bone (UAB). Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA) and Bone Structure was assessed by microcomputed tomography (μCT) with approximately 80 μm spatial resolution. We found all three QUS parameters to be significantly associated with Bone Structure independently of BMD. UVB was largely influenced by trabecular separation, UAB by connectivity, and BUA by a combination of both. For a one standard deviation (SD) increase in UVB, a decrease in trabecular separation of 1.2 SD was required compared with a 1.4 SD increase in BMD for the same effect. A 1.0 SD increase in UAB required a reduction in connectivity of 1.4 SD. Multivariate models of QUS versus BMD combined with Bone Structure parameters showed squared correlation coefficients of r2=0.70–0.85 for UVB, r2=0.27–0.56 for UAB, and r2=0.30–0.68 for BUA compared with r2=0.18–0.58 for UVB, r2
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Assessment of Bone Structure by Quantitative Computed Tomography
Computer Assisted Radiology Computergestützte Radiologie, 1991Co-Authors: Clausc Gluer, Stephan Grampp, Kenneth G. Faulkner, Peter Steiger, H K GenantAbstract:The assessment of Bone status by Bone densitometry techniques currently represents the most sensitive approach for predicting risk of fracture and for monitoring the progress of disease (e.g. osteoporosis) or the response to treatment. Limited success in predicting fracture risk in the individual patient as well as results obtained from in-vitro studies suggest that in addition to the average Bone mineral density (BMD) Bone Structure should be assessed.
Sharmila Majumdar - One of the best experts on this subject based on the ideXlab platform.
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assessment of trabecular Bone Structure of the calcaneus using multi detector ct correlation with microct and biomechanical testing
Bone, 2009Co-Authors: Thomas M. Link, Sharmila Majumdar, Andrew J. Burghardt, Gerd Diederichs, Marie Kentenich, Karsten Schwieger, Markus B Huber, Patrik RogallaAbstract:Abstract The prediction of Bone strength can be improved when determining Bone mineral density (BMD) in combination with measures of trabecular microarchitecture. The goal of this study was to assess parameters of trabecular Bone Structure and texture of the calcaneus by clinical multi-detector row computed tomography (MDCT) in an experimental in situ setup and to correlate these parameters with microCT (μCT) and biomechanical testing. Thirty calcanei in 15 intact cadavers were scanned using three different protocols on a 64-slice MDCT scanner with an in-plane pixel size of 208 μm and 500 μm slice thickness. Bone cores were harvested from each specimen and μCT images with a voxel size of 16 μm were obtained. After image coregistration, trabecular Bone Structure and texture were evaluated in identical regions on the MDCT images. After data acquisition, uniaxial compression testing was performed. Significant correlations between MDCT- and μCT-derived measures of Bone volume fraction (BV/TV), trabecular thickness (Tb.Th) and trabecular separation (Tb.Sp) were found (range, R 2 = 0.19–0.65, p p p
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relationship between trabecular Bone Structure and articular cartilage morphology and relaxation times in early oa of the knee joint using parallel mri at 3 t
Osteoarthritis and Cartilage, 2008Co-Authors: Radu Bolbos, Thomas M. Link, Sharmila Majumdar, Suchandrima Banerjee, Jin Zuo, C BenjaminAbstract:Summary Objective To evaluate trabecular Bone Structure in relationship with cartilage parameters in distal femur and proximal tibia of the human knee at 3Tesla (3T) using high-resolution magnetic resonance imaging (MRI) with parallel imaging. Method Sixteen healthy controls and 16 patients with mild osteoarthritis (OA) were studied using a 3T magnetic resonance (MR) scanner and an eight-channel phased-array knee coil. Axial 3D GeneRalized Autocalibrating Partially Parallel Acquisition (GRAPPA)-based phase cycled Fast Imaging Employing Steady State Acquisition (FIESTA-c) images were acquired in order to quantify the trabecular Bone Structure. For assessing cartilage morphology (thickness, volume), sagittal high-resolution 3D spoiled gradient echo (SPGR) images were acquired. In a subset of the subjects, sagittal images were acquired for measuring T1ρ and T2 relaxation times, using 3D T1ρ and T2 mapping techniques. Results Good measurement reproducibility was observed for Bone parameters, the coefficients of variations (CVs) ranging from 1.8% for trabecular number (app. Tb.N) to 5.5% for trabecular separation (app. Tb.Sp). Significant differences between control and OA groups were found for Bone volume fraction Bone volume over total volume (app. BV/TV) and app. Tb.Sp in all compartments. Significantly increased values in T1ρ and T2 were demonstrated in OA patients compared with controls at the femur, but not at the tibia. T1ρ was negatively correlated with app. BV/TV, app. Tb.N and app. Tb.Sp both at the medial femoral condyle (MFC) and lateral tibia (LT), while T2 was only correlated at the LT. Also, medial tibia (MT) T1ρ was negatively correlated with app. BV/TV ( R 2 =−0.49, P R 2 =−0.42, P Conclusion At this early stage of OA, an overall decrease in Bone Structure parameters and an increase in cartilage parameters (T1ρ, T2) were noticed in patients. Trabecular Bone Structure correlated with articular cartilage parameters suggesting that loss of mineralized Bone is associated with cartilage degeneration.
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Imaging Bone Structure and osteoporosis using MRI
Osteoporosis and the Osteoporosis of Rheumatic Diseases, 2006Co-Authors: Sandra J. Shefelbine, Sharmila MajumdarAbstract:In addition to Bone Mineral Density (BMD) Bone quality plays an important role in defining Bone strength. Trabecular Bone quality can potentially be defined by several factors, for example trabecular micro-architecture, matrix composition of trabeculae and trabecular Bone damage-repair. Considerable effort is being expended in developing techniques to assess trabecular Bone micro-architecture non-invasively. Site-specific Bone Structure information would significantly contribute to understanding the results of different therapeutic interventions, and potentially assist in optimizing the course of treatment. Three dimensional techniques that reveal trabecular Bone Structure are emerging as important contenders for defining Bone quality, at least partially. Techniques such as micro-computed tomography have recently been developed and provide high resolution images of the trabecular architecture. A more recent development in the assessment of trabecular Bone Structure is the use of magnetic resonance imaging techniques that make it possible to obtain non-invasive Bone biopsies at multiple anatomic sites. Cortical and trabecular Bone have a low water content and short T2 and are not detectable using routine MR imaging methods. However, the marrow surrounding the trabecular Bone network, if imaged at high resolution, reveals the trabecular network. Using such images, multiple different image processing and image analysis algorithms have been developed. The goal of all of these is to quantify the trabecular Bone Structure in 2 or 3 dimensions. The measures that have been derived so far are many, some of them synonymous with the histomorphometric measures such as trabecular Bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular spacing (TbSp), trabecular number (TbN), others include connectivity or Euler number, fractal dimension, tubularity, maximal entropy, etc. A number of calibration and validation studies (in vitro and in vivo) have been undertaken in which MR-derived measures of Structure are compared with measures derived from other modalities, such as histology, micro-CT, BMD, and with biomechanics. With recent advances in phased array coils and higher strength magnets, the potential of MR imaging of Bone Structure is ever increasing. At the present time, the skeletal sites most commonly imaged are the radius and calcaneus. Studies currently underway are exploring the possibility of obtaining micro-architectural features of trabecular Bone and the understanding whether Bone turnover and micro-architecture are related, and the underlying relationship between turnover, Bone mineral density and architecture, is the first step towards untraveling the therapeutic efficacy of different treatment regimens
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MicroCT evaluation of normal and osteoarthritic Bone Structure in human knee specimens.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2003Co-Authors: Vikas V. Patel, Michael D. Ries, Ahi Sema Issever, Andrew J. Burghardt, Andres Laib, Sharmila MajumdarAbstract:Although trabecular Bone Structure has been evaluated, variation with knee compartment and depth from joint surface is not completely understood. Cadaver knees were evaluated with microcomputed tomography analysis for these variations. Objective differences were compared between: medial vs. lateral compartments; femoral vs. tibial Bone; and normal vs. arthritic knees. Depth dependent changes in the parameters were observed for the first 6 mm of the cores in normal knees: BV/TV, Tb.N and Conn.D gradually decrease, while Tb.Sp and SMI increase. In the first 6 mm of the normal tibia BV/TV, Tb.N, and Tb.Th are greater than in the femur on both the medial and lateral compartments while Tb.Sp, SMI, and Conn.D are lower. The medial compartment values for BV/TV, Tb.N, Tb.Th and Conn.D are generally greater than for the lateral in both the femur and tibia while Tb.Sp and SMI are lower. In comparison of normal vs. arthritic knees significant differences are observed in the first 6 mm of the medial tibia. With arthritis BV/TV and Tb.Th are lower, while SMI and Tb.Sp are higher. Tb.N and Conn.D show no statistically significant difference. The Bone Structure variations are, thus, most prominent in the first 6 mm of depth and medial compartment Bone is generally more structurally sound than lateral. Severely arthritic Bone changes are most prominent in the medial compartment of the tibia and Bone Structure is less sound in severe arthritis.
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Magnetic resonance imaging of normal and osteoarthritic trabecular Bone Structure in the human knee.
Arthritis and rheumatism, 2002Co-Authors: Olivier Beuf, Thomas M. Link, David C. Newitt, Srinka Ghosh, Lynne S. Steinbach, Michael D. Ries, Nancy E Lane, Sharmila MajumdarAbstract:Objective To use high-resolution magnetic resonance imaging (MRI) to evaluate the trabecular Bone Structure in the distal femur and the proximal tibia and its to correlate the findings with different stages of osteoarthritis (OA) of the human knee. Methods Axial images of the distal femur and proximal tibia were obtained at 1.5 T in patients without and with mild OA and with severe OA. The spatial resolution was 195 × 195 μm2 with a 1-mm slice thickness. Apparent measures of trabecular Bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp), and trabecular thickness (Tb.Th) were calculated. Results Significant differences existed in the trabecular Bone Structure of the femur and tibia. Differences in trabecular Bone Structure between the tibia and the femur decreased with the degree of OA. The apparent BV/TV, Tb.N, and Tb.Sp in the femoral condyles could be used to differentiate healthy patients or patients with mild OA from patients with severe OA (P < 0.05). Among individuals, the structural variation of the lateral and medial femoral condyle was indicative of the extent of the disease. Conclusion High-resolution MRI of the knee joint can provide a noninvasive assessment of trabecular Bone Structure. Trabecular Bone Structure, determined by high-resolution MRI, shows significant variation in patients with varying degrees of OA. The impact of OA on trabecular Bone is different in the tibia than in the femur, and this difference depends on the extent of the disease.
Clausc Gluer - One of the best experts on this subject based on the ideXlab platform.
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three quantitative ultrasound parameters reflect Bone Structure
Calcified Tissue International, 1994Co-Authors: Clausc Gluer, M Jergas, Steven A Goldstein, H K GenantAbstract:We investigated whether quantitative ultrasound (QUS) parameters are associated with Bone Structure. In an in vitro study on 20 cubes of trabecular Bone, we measured broadband ultrasound attenuation (BUA) and two newly defined parameters—ultrasound velocity through Bone (UVB) and ultrasound attenuation in Bone (UAB). Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA) and Bone Structure was assessed by microcomputed tomography (μCT) with approximately 80 μm spatial resolution. We found all three QUS parameters to be significantly associated with Bone Structure independently of BMD. UVB was largely influenced by trabecular separation, UAB by connectivity, and BUA by a combination of both. For a one standard deviation (SD) increase in UVB, a decrease in trabecular separation of 1.2 SD was required compared with a 1.4 SD increase in BMD for the same effect. A 1.0 SD increase in UAB required a reduction in connectivity of 1.4 SD. Multivariate models of QUS versus BMD combined with Bone Structure parameters showed squared correlation coefficients of r2=0.70–0.85 for UVB, r2=0.27–0.56 for UAB, and r2=0.30–0.68 for BUA compared with r2=0.18–0.58 for UVB, r2<0.26 for UAB and r2<0.13 for BUA for models including BMD alone. QUS thus reflects Bone Structure, and a combined analysis of QUS and BMD will allow for a more comprehensive assessment of skeletal status than either method alone.
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Three quantitative ultrasound parameters reflect Bone Structure
Calcified tissue international, 1994Co-Authors: Clausc Gluer, M Jergas, Steven A Goldstein, H K GenantAbstract:We investigated whether quantitative ultrasound (QUS) parameters are associated with Bone Structure. In an in vitro study on 20 cubes of trabecular Bone, we measured broadband ultrasound attenuation (BUA) and two newly defined parameters—ultrasound velocity through Bone (UVB) and ultrasound attenuation in Bone (UAB). Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA) and Bone Structure was assessed by microcomputed tomography (μCT) with approximately 80 μm spatial resolution. We found all three QUS parameters to be significantly associated with Bone Structure independently of BMD. UVB was largely influenced by trabecular separation, UAB by connectivity, and BUA by a combination of both. For a one standard deviation (SD) increase in UVB, a decrease in trabecular separation of 1.2 SD was required compared with a 1.4 SD increase in BMD for the same effect. A 1.0 SD increase in UAB required a reduction in connectivity of 1.4 SD. Multivariate models of QUS versus BMD combined with Bone Structure parameters showed squared correlation coefficients of r2=0.70–0.85 for UVB, r2=0.27–0.56 for UAB, and r2=0.30–0.68 for BUA compared with r2=0.18–0.58 for UVB, r2
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Assessment of Bone Structure by Quantitative Computed Tomography
Computer Assisted Radiology Computergestützte Radiologie, 1991Co-Authors: Clausc Gluer, Stephan Grampp, Kenneth G. Faulkner, Peter Steiger, H K GenantAbstract:The assessment of Bone status by Bone densitometry techniques currently represents the most sensitive approach for predicting risk of fracture and for monitoring the progress of disease (e.g. osteoporosis) or the response to treatment. Limited success in predicting fracture risk in the individual patient as well as results obtained from in-vitro studies suggest that in addition to the average Bone mineral density (BMD) Bone Structure should be assessed.
Steven D Mittelman - One of the best experts on this subject based on the ideXlab platform.
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reciprocal relations of subcutaneous and visceral fat to Bone Structure and strength
Obstetrical & Gynecological Survey, 2010Co-Authors: Vicente Gilsanz, James Chalfant, David C Lee, Frederick Dorey, Steven D MittelmanAbstract:It has generally been believed that adiposity contributes to Bone health and protects against osteoporosis. A number of studies have shown a positive association between body weight or body mass index and Bone mass. In recent years, however, this long-held viewpoint has been challenged by reports suggesting that there is no positive association of fat mass and/or that there may be a negative relationship. There is accumulating evidence that the regional distribution pattern of fat deposition into the subcutaneous and visceral abdominal compartments may explain these conflicting data. Measurements of fat deposition into these 2 compartments may be a more meaningful predictor of disease risk than overall fat mass. The possible independent effects of subcutaneous abdominal fat (SAF) and visceral abdominal fat (VAF) on Bone health have not been previously investigated. This study investigated the effect of differential deposition of SAF and VAF on Bone Structure and/or Bone strength in the appendicular skeleton of 100 healthy young females 15 to 25 years of age, computed tomography was used for measurements of fat, Bone, and muscle phenotypes. Calculations of cross-sectional area, cortical Bone area, maximum and minimum principal moments of inertia, and polar moment of inertia, were made using multiple linear regression analysis. After adjusting for leg length and thigh musculature, the data showed that both SAF and VAF had strong and independent associations with femoral cross-sectional area, cortical Bone area, maximum and minimum principal moments of inertia, and polar moment of inertia (P < 0.03 for all comparisons). Although a positive predictive value was found for SAF with all femoral Bone phenotypes, there was a similar but negative effect between VAF and these measures (P < 0.01 for all comparisons). These findings indicate that SAF and VAF have opposing effects on the Structure and strength of Bone in young women. SAF has a strong beneficial effect on parameters of Bone Structure and strength, whereas VAF has a negative association with all Bone phenotypes.
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reciprocal relations of subcutaneous and visceral fat to Bone Structure and strength
The Journal of Clinical Endocrinology and Metabolism, 2009Co-Authors: Vicente Gilsanz, James Chalfant, David C Lee, Frederick Dorey, Steven D MittelmanAbstract:Context: Increased body fat is a risk factor for cardiovascular and metabolic disease, yet it is uncertain whether obesity protects against osteoporosis or adiposity is harmful to Bone. Objective: The aim of the study was to assess whether the pattern of adipose tissue deposition influences Bone Structure and strength. Design: The relations between sc and visceral adiposity and the cross-sectional dimensions and polar and principal moments of the femur in 100 healthy women ages 15 to 25 years were obtained using computed tomography. Results: Multiple linear regression analyses indicated that, after adjusting for leg length and thigh musculature, both sc and visceral fat had strong and independent associations with femoral cross-sectional area, cortical Bone area, principal moment maximum, principal moment minimum, and polar moment (all P values < 0.03). However, whereas sc fat had a positive predictive value with all femoral Bone phenotypes, a similar but negative effect was observed between visceral fat ...