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Viguet–Carrin S et al. – As PEN reflects non–enzymatic glycation of collagen and generally increases with bone age, the association between PEN and trabecular architecture suggests that the preserved trabeculae may contain mainly old bone and have undergone little remodeling. Thus, vertebral fragility may not only be due to alterations in bone architecture but also to modification of collagen cross–link patterns thereby influencing bone's mechanical behavior.

   

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