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Increased Cortical Porosity in Older Men With Fracture

Sundh, Daniel; Mellstrom, Dan; Nilsson, Martin; Karlsson, Magnus LU ; Ohlsson, Claes and Lorentzon, Mattias (2015) In Journal of Bone and Mineral Research 30(9). p.1692-1700
Abstract
Cortical porosity increases with age and affects bone strength, but its association with fracture in older men is unknown. The aim of this study was to investigate whether cortical porosity is associated with prevalent fractures in older men. A subsample of 456 men aged 80.2 +/- 3.5 (mean +/- SD) years, with available high-resolution peripheral quantitative computed tomography measurements at the tibia from the 5-year follow-up exam, was drawn from the prospective MrOS Gothenburg study. Dual-energy X-ray absorptiometry was used to measure areal bone mineral density (aBMD). Data on physical activity, calcium intake, medications, diseases, and smoking were collected on questionnaires at the follow-up exam. Of 87 men (19.1%) with fracture at... (More)
Cortical porosity increases with age and affects bone strength, but its association with fracture in older men is unknown. The aim of this study was to investigate whether cortical porosity is associated with prevalent fractures in older men. A subsample of 456 men aged 80.2 +/- 3.5 (mean +/- SD) years, with available high-resolution peripheral quantitative computed tomography measurements at the tibia from the 5-year follow-up exam, was drawn from the prospective MrOS Gothenburg study. Dual-energy X-ray absorptiometry was used to measure areal bone mineral density (aBMD). Data on physical activity, calcium intake, medications, diseases, and smoking were collected on questionnaires at the follow-up exam. Of 87 men (19.1%) with fracture at or after age 50 years (all fracture group), 52 (11.4%) had had a self-reported fracture before the baseline exam and 35 (7.7%) had had an X-ray-verified fracture between baseline and follow-up. Men in the all-fracture group and in the X-ray-verified group had 15.8% (13.2%+/- 4.9% versus 11.4%+/- 3.8%; p < 0.001) and 21.6% (14.1%+/- 5.2% versus 11.6%+/- 3.9%; p < 0.01) higher cortical porosity, respectively, than men in the nonfracture group. The independent associations between bone microstructure parameters and fracture were tested using multivariate logistic regression with age, height, weight, calcium intake, smoking, physical activity, medications, and diseases as covariates. Cortical porosity was independently associated with any fracture (reported or X-ray-verified; OR per SD increase 1.49; 95% confidence interval (CI), 1.17 to 1.90) and with any X-ray-verified fracture alone (OR 1.73; 95% CI, 1.23 to 2.42). Including aBMD (spine or hip, respectively) in the multivariate logistic regression above revealed that cortical porosity was associated with any fracture (OR 1.54; 95% CI, 1.17 to 2.01) and with X-ray-verified fracture alone (OR 1.49; 95% CI, 1.00 to 2.22). Cortical porosity was associated with prevalence of fracture even after adjustment for aBMD. (c) 2015 American Society for Bone and Mineral Research. (Less)
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Contribution to journal
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published
subject
keywords
OSTEOPOROSIS, BONE MINERAL DENSITY, MEN, FRACTURE, CORTICAL POROSITY
in
Journal of Bone and Mineral Research
volume
30
issue
9
pages
1692 - 1700
publisher
AMBMR
external identifiers
  • wos:000359866800017
  • scopus:84939568146
ISSN
1523-4681
DOI
10.1002/jbmr.2509
language
English
LU publication?
yes
id
e6853d33-20cd-4dd3-857e-bc438ba145ed (old id 7972184)
date added to LUP
2015-10-01 07:37:18
date last changed
2017-10-01 03:00:08
@article{e6853d33-20cd-4dd3-857e-bc438ba145ed,
  abstract     = {Cortical porosity increases with age and affects bone strength, but its association with fracture in older men is unknown. The aim of this study was to investigate whether cortical porosity is associated with prevalent fractures in older men. A subsample of 456 men aged 80.2 +/- 3.5 (mean +/- SD) years, with available high-resolution peripheral quantitative computed tomography measurements at the tibia from the 5-year follow-up exam, was drawn from the prospective MrOS Gothenburg study. Dual-energy X-ray absorptiometry was used to measure areal bone mineral density (aBMD). Data on physical activity, calcium intake, medications, diseases, and smoking were collected on questionnaires at the follow-up exam. Of 87 men (19.1%) with fracture at or after age 50 years (all fracture group), 52 (11.4%) had had a self-reported fracture before the baseline exam and 35 (7.7%) had had an X-ray-verified fracture between baseline and follow-up. Men in the all-fracture group and in the X-ray-verified group had 15.8% (13.2%+/- 4.9% versus 11.4%+/- 3.8%; p &lt; 0.001) and 21.6% (14.1%+/- 5.2% versus 11.6%+/- 3.9%; p &lt; 0.01) higher cortical porosity, respectively, than men in the nonfracture group. The independent associations between bone microstructure parameters and fracture were tested using multivariate logistic regression with age, height, weight, calcium intake, smoking, physical activity, medications, and diseases as covariates. Cortical porosity was independently associated with any fracture (reported or X-ray-verified; OR per SD increase 1.49; 95% confidence interval (CI), 1.17 to 1.90) and with any X-ray-verified fracture alone (OR 1.73; 95% CI, 1.23 to 2.42). Including aBMD (spine or hip, respectively) in the multivariate logistic regression above revealed that cortical porosity was associated with any fracture (OR 1.54; 95% CI, 1.17 to 2.01) and with X-ray-verified fracture alone (OR 1.49; 95% CI, 1.00 to 2.22). Cortical porosity was associated with prevalence of fracture even after adjustment for aBMD. (c) 2015 American Society for Bone and Mineral Research.},
  author       = {Sundh, Daniel and Mellstrom, Dan and Nilsson, Martin and Karlsson, Magnus and Ohlsson, Claes and Lorentzon, Mattias},
  issn         = {1523-4681},
  keyword      = {OSTEOPOROSIS,BONE MINERAL DENSITY,MEN,FRACTURE,CORTICAL POROSITY},
  language     = {eng},
  number       = {9},
  pages        = {1692--1700},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Increased Cortical Porosity in Older Men With Fracture},
  url          = {http://dx.doi.org/10.1002/jbmr.2509},
  volume       = {30},
  year         = {2015},
}