Femoral neck geometry and hip fracture risk: the Geelong osteoporosis study
Femoral neck geometry and hip fracture risk: the Geelong osteoporosis study
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DOI：
10.1007/s00198-005-1988-z
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发表时间：
2005-10-01
影响因子：
4
通讯作者：
Kotowicz, MA
中科院分区：
文献类型：
--
作者：
El-Kaissi, S;Pasco, JA;Kotowicz, MA
为了确定绝经后白人女性股骨颈几何形状与髋部骨折风险之间的关系，我们进行了一项回顾性研究，比较了62例髋部骨折病例与608例随机选择的对照组的股骨颈尺寸。使用制造商的标尺功能，通过双能X线吸收测量扫描（Lunar DPX-L）进行测量，包括：髋关节轴长（HAL）、股骨颈轴长（FNAL）、股骨颈宽度（FNW）、股骨干宽度（FSW）、股骨干内侧皮质厚度（FSCTmed）和股骨干外侧皮质厚度（FSCTlat）。与对照组相比，骨折组年龄较大（中位年龄78.3岁vs 73.8岁），体重较轻（中位体重59.9 kg vs 64.5 kg），调整年龄后，身高较高（平均身高158.7 +/- 0.8 cm vs 156.7 +/- 0.2 cm）。此外，该组的骨密度较低（0.682 +/- 0.016 g/cm（2）vs 0.791 +/- 0.006 g/cm（2））。在调整年龄、骨矿物质含量（BMC）或身高后，髋部骨折患者的FNW（高达6.6%）和FSW（高达6.3%）高于对照组。FNW和FSW每增加一个标准差，骨折风险分别增加1.7倍（95%CI 1.3-2.3）和2.4倍（95%CI 1.8-3.2）。骨折组的BMC校正FNAL（+2.1%）大于对照组，而年龄校正FSCT中位数降低（-7.2%）。在调整年龄或BMC后，骨折患者的HAL有延长的趋势（高达2.1%），而年龄调整后的FSCTlat（-1.7%）则没有达到统计学显著性。在多因素分析中，年龄、FNW、FSW、BMC和FSCTmed的组合预测髋部骨折的风险。由于骨折病例中HAL测量值较少，因此未分析HAL。我们的结论是，绝经后妇女髋部骨折有较宽的股骨颈和股骨干，股骨皮质较薄，股骨颈轴长比没有骨折的妇女。髋关节几何形状的改变与髋关节骨折的风险相关。
To determine the relationship between femoral neck geometry and the risk of hip fracture in post-menopausal Caucasian women, we conducted a retrospective study comparing the femoral neck dimensions of 62 hip fracture cases to those of 608 randomly selected controls. Measurements were made from dual-energy X-ray absorptiometry scans (Lunar DPX-L), using the manufacturer's ruler function, and included: hip axis length (HAL), femoral neck axis length (FNAL), femoral neck width (FNW), femoral shaft width (FSW), medial femoral shaft cortical thickness (FSCTmed), and lateral femoral shaft cortical thickness (FSCTlat). The fracture group was older (median age 78.3 years vs 73.8 years), lighter (median weight 59.9 kg vs 64.5 kg), and, after adjustment for age, taller (mean height 158.7 +/- 0.8 cm vs 156.7 +/- 0.2 cm) than the controls. Furthermore, bone mineral density was lower in this group (0.682 +/- 0.016 g/cm(2) vs 0.791 +/- 0.006 g/cm(2)). After adjustment for age, bone mineral content (BMC) or height, hip fracture patients had greater FNW (up to 6.6%) and FSW (up to 6.3%) than did the controls. Each standard deviation increase in FNW and FSW was associated with a 1.7-fold (95% CI 1.3-2.3) and a 2.4-fold (95% CI 1.8-3.2) increase in the fracture risk, respectively. BMC-adjusted FNAL was greater in the fracture group (+2.1%) than in the controls, while the age-adjusted FSCTmed was reduced (-7.2%). There was a trend towards longer HAL (up to 2.1%) after adjustment for age or BMC, and thinner age-adjusted FSCTlat (-1.7%) in fracture patients that did not reach statistical significance. In multivariate analysis, the risk of hip fracture was predicted by the combination of age, FNW, FSW, BMC and FSCTmed. HAL was not analyzed because of the small number of HAL measurements among fracture cases. We conclude that post-menopausal women with hip fractures have wider femoral necks and shafts, thinner femoral cortices and longer femoral neck axis lengths than do women with no fractures. Alteration in hip geometry is associated with the risk of hip fracture.