Cortical bone area predicts incident fractures independently of areal bone mineral density in older men
(2017) In Journal of Clinical Endocrinology and Metabolism 102(2). p.516-524- Abstract
Context: Areal bone mineral density (aBMD) measured using dual-energy X-ray absorptiometry (DXA) is used clinically to predict fracture but does not discriminate between trabecular and cortical bone assessment. Objective: This study aimed to investigate whether information on cortical and trabecular bone predict fracture risk independently of aBMD and clinical risk factors. Design and Participants: Cortical area, bonemass, porosity, and trabecular bone volume fraction (BVTV) were measured at the tibia using high-resolution peripheral quantitative computed tomography (HRpQCT) in 456 men (80.2 ± 3.5 years) recruited from the general population in Gothenburg, Sweden. ABMD was measured using DXA. Incident fractures (71 men) were X-ray... (More)
Context: Areal bone mineral density (aBMD) measured using dual-energy X-ray absorptiometry (DXA) is used clinically to predict fracture but does not discriminate between trabecular and cortical bone assessment. Objective: This study aimed to investigate whether information on cortical and trabecular bone predict fracture risk independently of aBMD and clinical risk factors. Design and Participants: Cortical area, bonemass, porosity, and trabecular bone volume fraction (BVTV) were measured at the tibia using high-resolution peripheral quantitative computed tomography (HRpQCT) in 456 men (80.2 ± 3.5 years) recruited from the general population in Gothenburg, Sweden. ABMD was measured using DXA. Incident fractures (71 men) were X-ray verified. Associations were evaluated using Cox regression. Results: Cortical area [hazard ratio (HR) per standard deviation (SD) decrease, 2.05; 95% confidence interval (CI), 1.58 to 2.65], cortical bone mass (HR, 2.07; 95% CI, 1.58 to 2.70), and BVTV (HR, 1.62; 95% CI, 1.26 to 2.07), but not cortical porosity, were independently associated with fracture risk. These associations remained after adjustment for femoral neck aBMD and Fracture Risk Assessment risk factors (area: HR 1.96, 95% CI, 1.44 to 2.66; mass: HR 1.99, 95% CI, 1.45 to 2.74; BV/TV: HR 1.46, 95% CI, 1.09 to 1.96). After entering BV/TV and cortical area or bone mass simultaneously in the adjusted models, only the cortical parameters remained important predictors of fracture. Conclusion: HR-pQCT measurement of cortical area and mass might add clinically useful information for the evaluation of fracture risk.
(Less)
- author
- Ohlsson, Claes ; Sundh, Daniel ; Wallerek, Andreas ; Nilsson, Martin ; Karlsson, Magnus LU ; Johansson, Helena ; Mellström, Dan and Lorentzon, Mattias
- organization
- publishing date
- 2017-02-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Clinical Endocrinology and Metabolism
- volume
- 102
- issue
- 2
- pages
- 9 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:27875059
- wos:000397240900023
- scopus:85012081819
- ISSN
- 0021-972X
- DOI
- 10.1210/jc.2016-3177
- language
- English
- LU publication?
- yes
- id
- 97dd5c51-1fee-468d-b28d-772baf6fb0c6
- date added to LUP
- 2017-02-28 07:46:40
- date last changed
- 2024-06-23 12:32:25
@article{97dd5c51-1fee-468d-b28d-772baf6fb0c6, abstract = {{<p>Context: Areal bone mineral density (aBMD) measured using dual-energy X-ray absorptiometry (DXA) is used clinically to predict fracture but does not discriminate between trabecular and cortical bone assessment. Objective: This study aimed to investigate whether information on cortical and trabecular bone predict fracture risk independently of aBMD and clinical risk factors. Design and Participants: Cortical area, bonemass, porosity, and trabecular bone volume fraction (BVTV) were measured at the tibia using high-resolution peripheral quantitative computed tomography (HRpQCT) in 456 men (80.2 ± 3.5 years) recruited from the general population in Gothenburg, Sweden. ABMD was measured using DXA. Incident fractures (71 men) were X-ray verified. Associations were evaluated using Cox regression. Results: Cortical area [hazard ratio (HR) per standard deviation (SD) decrease, 2.05; 95% confidence interval (CI), 1.58 to 2.65], cortical bone mass (HR, 2.07; 95% CI, 1.58 to 2.70), and BVTV (HR, 1.62; 95% CI, 1.26 to 2.07), but not cortical porosity, were independently associated with fracture risk. These associations remained after adjustment for femoral neck aBMD and Fracture Risk Assessment risk factors (area: HR 1.96, 95% CI, 1.44 to 2.66; mass: HR 1.99, 95% CI, 1.45 to 2.74; BV/TV: HR 1.46, 95% CI, 1.09 to 1.96). After entering BV/TV and cortical area or bone mass simultaneously in the adjusted models, only the cortical parameters remained important predictors of fracture. Conclusion: HR-pQCT measurement of cortical area and mass might add clinically useful information for the evaluation of fracture risk.</p>}}, author = {{Ohlsson, Claes and Sundh, Daniel and Wallerek, Andreas and Nilsson, Martin and Karlsson, Magnus and Johansson, Helena and Mellström, Dan and Lorentzon, Mattias}}, issn = {{0021-972X}}, language = {{eng}}, month = {{02}}, number = {{2}}, pages = {{516--524}}, publisher = {{Oxford University Press}}, series = {{Journal of Clinical Endocrinology and Metabolism}}, title = {{Cortical bone area predicts incident fractures independently of areal bone mineral density in older men}}, url = {{http://dx.doi.org/10.1210/jc.2016-3177}}, doi = {{10.1210/jc.2016-3177}}, volume = {{102}}, year = {{2017}}, }