TY - JOUR
T1 - Histomorphometric parameters of iliac bone in healthy individuals
T2 - Systematic review and meta-analysis
AU - Ferreira, Aníbal
AU - dos Reis, Luciene Machado
AU - Manteigas, David
AU - Carvalho, Aluizio Barbosa
AU - Jorgetti, Vanda
N1 - Funding Information:
Medical writing assistance, technical editing, and statistical analyses were supported by the Center for Research and Development in the Nephrology Area (NIDAN), a non-profit organization. The funding source was not involved in the study design; collection, analysis, and interpretation of data; writing of the report; or the decision to submit the paper for publication.
Publisher Copyright:
© 2024
PY - 2025/1
Y1 - 2025/1
N2 - Despite its invasive character, bone biopsy followed by histomorphometry remains the gold standard for diagnosing and classifying many metabolic bone diseases. However, the interpretation of histomorphometric parameters requires comparison with average values obtained from a proper control group, which are only available for some populations, and reference standards still need to be published. Therefore, our objective was to estimate average values for bone histomorphometric parameters overall, by age, gender, and race (White and Black) categories of healthy adult individuals, based on a systematic review and meta-analysis of clinical studies. Relevant studies published in English with available results until December 2020 were identified by PubMed (Medline) search and consulting experts in the field. Out of 447 potentially relevant studies, 37 met the inclusion criteria. Meta-analysis using fixed-effects models was used to pool mean estimates and 95% confidence intervals (CI) for 16 bone histomorphometry parameters. An age-by-gender trend was observed in most histomorphometry parameters. The mean estimates of bone volume/tissue volume (BV/TV), trabecular thickness (Tb.Th), and trabecular number (Tb.N) decreased. In contrast, trabecular separation (Tb.Sp) increased from the youngest to the oldest age categories in both genders. Osteoblast surface (Ob.S/BS) and osteoclast surface (Oc.S/BS) decreased across all age categories in males. Mineralizing surface (MS/BS) increased from the youngest to the oldest age categories in females, while mineralization lag time (Mlt) increased in both genders. Furthermore, gender and race had a significant effect on several histomorphometry parameters. In conclusion, this meta-analysis provided mean estimates for normal values of histomorphometric parameters that clinicians may use when evaluating bone biopsies in patients. This enables the direct comparison of patients' histomorphometric values with the suitable reference group regarding age, gender, and race.
AB - Despite its invasive character, bone biopsy followed by histomorphometry remains the gold standard for diagnosing and classifying many metabolic bone diseases. However, the interpretation of histomorphometric parameters requires comparison with average values obtained from a proper control group, which are only available for some populations, and reference standards still need to be published. Therefore, our objective was to estimate average values for bone histomorphometric parameters overall, by age, gender, and race (White and Black) categories of healthy adult individuals, based on a systematic review and meta-analysis of clinical studies. Relevant studies published in English with available results until December 2020 were identified by PubMed (Medline) search and consulting experts in the field. Out of 447 potentially relevant studies, 37 met the inclusion criteria. Meta-analysis using fixed-effects models was used to pool mean estimates and 95% confidence intervals (CI) for 16 bone histomorphometry parameters. An age-by-gender trend was observed in most histomorphometry parameters. The mean estimates of bone volume/tissue volume (BV/TV), trabecular thickness (Tb.Th), and trabecular number (Tb.N) decreased. In contrast, trabecular separation (Tb.Sp) increased from the youngest to the oldest age categories in both genders. Osteoblast surface (Ob.S/BS) and osteoclast surface (Oc.S/BS) decreased across all age categories in males. Mineralizing surface (MS/BS) increased from the youngest to the oldest age categories in females, while mineralization lag time (Mlt) increased in both genders. Furthermore, gender and race had a significant effect on several histomorphometry parameters. In conclusion, this meta-analysis provided mean estimates for normal values of histomorphometric parameters that clinicians may use when evaluating bone biopsies in patients. This enables the direct comparison of patients' histomorphometric values with the suitable reference group regarding age, gender, and race.
KW - Bone biopsy
KW - Control groups
KW - Histomorphometry
KW - Reference values
KW - Trabecular bone
UR - http://www.scopus.com/inward/record.url?scp=85208069206&partnerID=8YFLogxK
U2 - 10.1016/j.bone.2024.117309
DO - 10.1016/j.bone.2024.117309
M3 - Review article
AN - SCOPUS:85208069206
SN - 8756-3282
VL - 190
JO - Bone
JF - Bone
M1 - 117309
ER -
