HBM cases (age range 26–87 years) were younger than population controls (range 65–74 years), but older than family controls selleck compound (range 19–88 years) (Table 1). HBM cases were heavier with greater BMI than both control groups. A higher proportion of HBM cases were female than in the control groups, and although population controls were almost all postmenopausal, HBM cases had more experience of estrogen replacement therapy. Age at menarche was similar between HBM cases and family controls (mean [SD]

12.8 [1.6] and 12.6 [1.5] years respectively, p = 0.869). HBM cases were more likely to report a history of cancer and steroid use. No participants gave a history of hepatitis C or excess fluoride ingestion. All

study participants were of white European origin. Selleckchem Target Selective Inhibitor Library No consanguinity was reported. In unadjusted analyses, HBM cases had substantially greater TBA at the distal tibia (4% site) than both family and population controls (Table 2). Similar results were obtained after adjustment for confounding factors (age, gender, weight and height, alcohol consumption, smoking status, malignancy and steroid and estrogen replacement use), with a mean difference of just over 2 cm2, between HBM cases and both control groups (equivalent to a 19% increase above that of both family and population controls) (Table 3, Fig. 1). At the mid-tibia (66% site), after similar adjustment TBA was also greater in HBM cases compared with both control groups, although this difference was smaller in proportion to those changes observed distally; mid-tibial TBA in HBM cases was approximately 4% tuclazepam and 8% larger compared with family and population controls respectively (Table 3, Fig. 1). Consistent with these increases in TBA, mid-tibia periosteal circumference was also increased in HBM cases compared with family controls (adjusted mean difference 1.72 [95%CI − 0.06, 3.49] mm, p = 0.058) and population controls (3.80 [2.59, 5.00] mm, p < 0.001). Mid-tibial cortices were thicker in HBM,

in unadjusted and adjusted analyses, as compared with both family and population controls (Table 2 and Table 3). After adjustment HBM cases had on average 0.5 mm thicker cortices compared with family and population controls respectively (Table 3, Fig. 1). Furthermore, at the mid-tibia, CBA and CBA/TBA were also greater in HBM cases compared with both control groups, suggesting a greater proportion of the cross-section of bone was cortical. Although cortical thickness measured distally can be unreliable, before adjustment HBM cases appeared to have increased cortical thickness compared with population controls (Table 2). After adjustment HBM cases had on average 37% and 112% thicker cortices compared with family and population controls respectively (Table 3).