Male-female differences in the association between incident hip fracture and proximal femoral strength: a finite element analysis study.
Male-female differences in the association between incident hip fracture and proximal femoral strength: a finite element analysis study.
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DOI：
10.1016/j.bone.2011.03.682
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发表时间：
2011-06-01
期刊：
影响因子：
4.1
通讯作者：
Lang, T. F.
中科院分区：
文献类型：
--
作者：
Keyak, J. H.;Sigurdsson, S.;Karlsdottir, G.;Oskarsdottir, D.;Sigmarsdottir, A.;Zhao, S.;Kornak, J.;Harris, T. B.;Sigurdsson, G.;Jonsson, B. Y.;Siggeirsdottir, K.;Eiriksdottir, G.;Gudnason, V.;Lang, T. F.
关键词：
髋部骨折风险通常使用双能 X 射线吸收测定法 (DXA) 或定量计算机断层扫描 (QCT) 进行评估，这些方法提供近端股骨强度的替代测量。然而，通过将 QCT 与有限元 (FE) 分析相结合，可以最好地明确估计近端股骨强度。为了评估这种预测老年男性和女性髋部骨折的技术，我们在年龄基因/环境易感性 (AGES) 雷克雅未克队列中进行了一项巢式年龄和性别匹配病例对照研究。获得了 5500 名受试者的基线（骨折前）QCT 扫描。在 4-7 年的随访中，51 名男性和 77 名女性发生髋部骨折。随机选择 97 名男性和 152 名女性作为年龄和性别匹配的对照。根据 QCT 数据计算每个受试者左髋的 FE-站立强度 (FStance) 和后外侧跌倒 (FFall) 负载，以及股骨总面积骨矿物质密度 (aBMD)。在控制人口统计参数后，发生髋部骨折的受试者的 FStance 和 Fall 比对照受试者低 13%–25% (p≤0.006)。考虑到男性骨折受试者的 FStance 和 FFall 大于女性（p<0.001），男性骨折受试者和对照受试者的 FE 强度之间的差异（站立，22%；跌倒，25%）不成比例地大于女性（站立，13%；跌倒，18%）（p≤0.033）。对于男性来说，考虑 aBMD 后，FStance 与髋部骨折相关（p=0.013）。这些数据表明 FStance 提供的有关骨折风险的信息超出了 aBMD 提供的信息 (p=0.013)。这些发现支持进一步探索髋部骨折预测因素中可能存在的性别差异，以及使用有限元分析来管理骨质疏松症的性别特异性策略。
Hip fracture risk is usually evaluated using dual energy x-ray absorptiometry (DXA) or quantitative computed tomography (QCT) which provide surrogate measures for proximal femoral strength. However, proximal femoral strength can best be estimated explicitly by combining QCT with finite element (FE) analysis. To evaluate this technique for predicting hip fracture in older men and women, we performed a nested age- and sex-matched case-control study in the Age Gene/Environment Susceptibility (AGES) Reykjavik cohort. Baseline (pre-fracture) QCT scans of 5500 subjects were obtained. During 4–7 years follow-up, 51 men and 77 women sustained hip fractures. Ninety-seven men and 152 women were randomly selected as age- and sex-matched controls. FE-strength of the left hip of each subject for stance (FStance) and posterolateral fall (FFall) loading, and total femur areal bone mineral density (aBMD) were computed from the QCT data. FStance and FFall in incident hip fracture subjects were 13%–25% less than in control subjects (p≤0.006) after controlling for demographic parameters. The difference between FE strengths of fracture and control subjects was disproportionately greater in men (stance, 22%; fall, 25%) than in women (stance, 13%; fall, 18%) (p≤0.033), considering that FStance and FFall in fracture subjects were greater in men than in women (p<0.001). For men, FStance was associated with hip fracture after accounting for aBMD (p=0.013). These data indicate that FStance provides information about fracture risk that is beyond that provided by aBMD (p=0.013). These findings support further exploration of possible sex differences in the predictors of hip fracture and of sex-specific strategies for using FE analysis to manage osteoporosis.
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DOI：
10.1115/1.2895414
发表时间：
1991-11-01
影响因子：
1.7
作者：
ROBINOVITCH, SN;HAYES, WC;MCMAHON, TA
通讯作者：
MCMAHON, TA
DOI：
10.1097/01.blo.0000164400.37905.22
发表时间：
2005-08-01
影响因子：
4.2
作者：
Keyak, JH;Kaneko, TS;Skinner, HB
通讯作者：
Skinner, HB
DOI：
10.1359/jbmr.090807
发表时间：
2010-03
期刊：
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
影响因子：
--
作者：
Lang T;Cauley JA;Tylavsky F;Bauer D;Cummings S;Harris TB;Health ABC Study
通讯作者：
Health ABC Study
影响因子：
4.1
作者：
Keyak, J. H.;Koyama, A. K.;Lang, T. F.
通讯作者：
Lang, T. F.
影响因子：
2.4
作者：
Keyak, JH;Rossi, SA
通讯作者：
Rossi, SA