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Contribution of hip strength indices to hip fracture risk in elderly men and women

Ahlborg, Henrik LU ; Nguyen, ND; Nguyen, TV; Center, JR and Eisman, JA (2005) In Journal of Bone and Mineral Research 20(10). p.1820-1827
Abstract
In this prospective, case-control study, femoral neck diameter, cross-sectional moment of inertia, or section modulus was an independent predictor of hip fracture risk after adjustment for BMD. However, the contribution of each of these indices to hip fracture prediction was modest in the presence of BMD. Introduction: The relative contribution of measures of hip strength to hip fracture prediction is unclear. This study was designed to characterize the association between hip strength indices and hip fracture risk in relation to BMD in elderly men and women. Materials and Methods: Seventy-one women and 25 men >= 60 years of age, who sustained a hip fracture during the study period of 1989-2003, were selected from the prospective,... (More)
In this prospective, case-control study, femoral neck diameter, cross-sectional moment of inertia, or section modulus was an independent predictor of hip fracture risk after adjustment for BMD. However, the contribution of each of these indices to hip fracture prediction was modest in the presence of BMD. Introduction: The relative contribution of measures of hip strength to hip fracture prediction is unclear. This study was designed to characterize the association between hip strength indices and hip fracture risk in relation to BMD in elderly men and women. Materials and Methods: Seventy-one women and 25 men >= 60 years of age, who sustained a hip fracture during the study period of 1989-2003, were selected from the prospective, population-based Dubbo Osteoporosis Epidemiology Study. These fracture cases were randomly matched for age and sex in a 1:2 ratio with non-fracture individuals. BMD at the femoral neck was measured before the fracture event by DXA (Lunar DPX-L). Hip strength indices, including femoral neck diameter (FND), cross-sectional moment of inertia (CSMI), and section modulus (Z), were estimated by reanalysis of the image files using hip strength analysis software. Results: In women, after adjustment for BMD, increased risk of hip fracture was associated with smaller FND (OR, 1.6; 95% CI, 1.0, 2.7), lower CSMI (OR, 1.8; 95% Cl, 1.0, 3.2), or Z (OR, 1.6; 95% Cl, 1.1, 5.1). In men, none of these hip strength indices were significant predictors of fracture risk. However, using the results in women as a prior distribution, it was estimated that the BMD-adjusted OR for FND (OR, 1.5; 95% CI, 1.0, 2.3), CSMI (OR, 1.6; 95% CI, 1.0, 2.5), or Z (OR, 2.3; 95% Cl, 1.4,3.9) was each significantly associated with hip fracture risk in men. In the logistic regression model, BMD alone accounted for 32% and 16% of the variance of fracture liability in women and men, respectively. The addition of FND, CSMI, or Z to the model increased the respective variance proportion to 34% and 19%. Conclusions: These data suggest that smaller FND and lower CSMI or Z is an independent risk factor for hip fracture in both women and men. However, the contribution of these measures to hip fracture prediction over and above BMD is likely modest. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
osteoporosis, hip fracture, BMD, DXA, hip strength analysis
in
Journal of Bone and Mineral Research
volume
20
issue
10
pages
1820 - 1827
publisher
AMBMR
external identifiers
  • wos:000232062900012
  • pmid:16160739
  • scopus:25444484395
ISSN
1523-4681
DOI
10.1359/JBMR.050519
language
English
LU publication?
yes
id
4acb001e-4bc5-4004-9b01-016cce058d7a (old id 891659)
date added to LUP
2008-01-11 09:50:46
date last changed
2017-10-01 03:53:57
@article{4acb001e-4bc5-4004-9b01-016cce058d7a,
  abstract     = {In this prospective, case-control study, femoral neck diameter, cross-sectional moment of inertia, or section modulus was an independent predictor of hip fracture risk after adjustment for BMD. However, the contribution of each of these indices to hip fracture prediction was modest in the presence of BMD. Introduction: The relative contribution of measures of hip strength to hip fracture prediction is unclear. This study was designed to characterize the association between hip strength indices and hip fracture risk in relation to BMD in elderly men and women. Materials and Methods: Seventy-one women and 25 men >= 60 years of age, who sustained a hip fracture during the study period of 1989-2003, were selected from the prospective, population-based Dubbo Osteoporosis Epidemiology Study. These fracture cases were randomly matched for age and sex in a 1:2 ratio with non-fracture individuals. BMD at the femoral neck was measured before the fracture event by DXA (Lunar DPX-L). Hip strength indices, including femoral neck diameter (FND), cross-sectional moment of inertia (CSMI), and section modulus (Z), were estimated by reanalysis of the image files using hip strength analysis software. Results: In women, after adjustment for BMD, increased risk of hip fracture was associated with smaller FND (OR, 1.6; 95% CI, 1.0, 2.7), lower CSMI (OR, 1.8; 95% Cl, 1.0, 3.2), or Z (OR, 1.6; 95% Cl, 1.1, 5.1). In men, none of these hip strength indices were significant predictors of fracture risk. However, using the results in women as a prior distribution, it was estimated that the BMD-adjusted OR for FND (OR, 1.5; 95% CI, 1.0, 2.3), CSMI (OR, 1.6; 95% CI, 1.0, 2.5), or Z (OR, 2.3; 95% Cl, 1.4,3.9) was each significantly associated with hip fracture risk in men. In the logistic regression model, BMD alone accounted for 32% and 16% of the variance of fracture liability in women and men, respectively. The addition of FND, CSMI, or Z to the model increased the respective variance proportion to 34% and 19%. Conclusions: These data suggest that smaller FND and lower CSMI or Z is an independent risk factor for hip fracture in both women and men. However, the contribution of these measures to hip fracture prediction over and above BMD is likely modest.},
  author       = {Ahlborg, Henrik and Nguyen, ND and Nguyen, TV and Center, JR and Eisman, JA},
  issn         = {1523-4681},
  keyword      = {osteoporosis,hip fracture,BMD,DXA,hip strength analysis},
  language     = {eng},
  number       = {10},
  pages        = {1820--1827},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Contribution of hip strength indices to hip fracture risk in elderly men and women},
  url          = {http://dx.doi.org/10.1359/JBMR.050519},
  volume       = {20},
  year         = {2005},
}