Assessment of incident spine and hip fractures in women and men using finite element analysis of CT scans.
Assessment of incident spine and hip fractures in women and men using finite element analysis of CT scans.
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DOI：
10.1002/jbmr.2069
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发表时间：
2014-03
影响因子：
6.2
通讯作者：
Keaveny, Tony M.
中科院分区：
文献类型：
--
作者：
Kopperdahl, David L.;Aspelund, Thor;Hoffmann, Paul F.;Sigurdsson, Sigurdur;Siggeirsdottir, Kristin;Harris, Tamara B.;Gudnason, Vilmundur;Keaveny, Tony M.
计算机断层扫描（CT）扫描的有限元分析提供了脊柱和髋关节骨强度的非侵入性估计。为了进一步验证这些估计临床，我们进行了一项为期五年的病例对照研究，1110名妇女和男子年龄超过65岁的AGES-Reykjavik队列（例=事件脊柱或髋部骨折;对照=没有事件脊柱或髋部骨折，分别）。从基线CT扫描开始，我们测量股骨和椎骨强度，以及髋关节（仅区域BMD）和腰椎（仅小梁体积BMD）的骨矿物质密度（BMD）。我们发现，对于X线证实的脊柱骨折事件（n=167），女性（2.8，95% CI：1.8-4.3）和男性（2.2，95% CI：1.5-3.2）的年龄调整后的椎体强度比值比具有显著性，男性仍具有显著性（p=0.01），与椎体小梁体积BMD无关。对于髋部骨折（n=171），女性股骨强度的年龄调整优势比显著（4.2，95% CI：2.6-6.9）和男性（3.5，95% CI：2.3-5.3），在调整女性股骨颈区域BMD和两性全髋区域BMD后仍具有显著性;结合股骨强度和股骨颈区域BMD，女性骨折分类得到改善（p=0.002）。对于两种性别，在基于BMD的骨质疏松症干预阈值和相应的“脆性骨强度”预先设定阈值（脊柱：女性≤ 4，500 N，男性≤ 6，500 N;髋部：女性≤ 3，000 N，男性≤ 3，500 N）下，脊柱和髋部骨折的概率相似地高。由于已经确定，65岁以上的人谁有骨质疏松症在髋部或脊柱骨密度标准应被视为骨折的高风险，这些结果表明，个人谁有“脆弱的骨强度”在髋部或脊柱也应被视为骨折的高风险。
Finite element analysis of computed tomography (CT) scans provides non-invasive estimates of bone strength at the spine and hip. To further validate such estimates clinically, we performed a five-year case-control study of 1110 women and men over age 65 from the AGES-Reykjavik cohort (case = incident spine or hip fracture; control = no incident spine or hip fracture, respectively). From the baseline CT scans, we measured femoral and vertebral strength, as well as bone mineral density (BMD) at the hip (areal BMD only) and lumbar spine (trabecular volumetric BMD only). We found that, for incident radiographically-confirmed spine fractures (n=167), the age-adjusted odds ratio for vertebral strength was significant for women (2.8, 95% CI: 1.8–4.3) and men (2.2, 95% CI: 1.5–3.2), and for men, remained significant (p=0.01) independent of vertebral trabecular volumetric BMD. For incident hip fractures (n=171), the age-adjusted odds ratio for femoral strength was significant for women (4.2, 95% CI: 2.6–6.9) and men (3.5, 95% CI: 2.3–5.3) and remained significant after adjusting for femoral neck areal BMD in women and for total hip areal BMD in both sexes; fracture classification improved for women by combining femoral strength with femoral neck areal BMD (p=0.002). For both sexes, the probabilities of spine and hip fractures were similarly high at the BMD-based interventional thresholds for osteoporosis and at corresponding pre-established thresholds for “fragile bone strength” (spine: women ≤ 4,500 N, men ≤ 6,500 N; hip: women ≤ 3,000 N, men ≤ 3,500 N). Since it is well established that individuals over age 65 who have osteoporosis at the hip or spine by BMD criteria should be considered at high risk of fracture, these results indicate that individuals who have “fragile bone strength” at the hip or spine should also be considered at high risk of fracture.
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影响因子：
--
作者：
Berrington de González A;Mahesh M;Kim KP;Bhargavan M;Lewis R;Mettler F;Land C
通讯作者：
Land C
影响因子：
4
作者：
Dall'Ara, E.;Pahr, D.;Zysset, P.
通讯作者：
Zysset, P.
影响因子：
4.1
作者：
Graeff, Christian;Marin, Fernando;Glueer, Claus-Christian
通讯作者：
Glueer, Claus-Christian
DOI：
10.1111/j.1749-6632.2009.05348.x
发表时间：
2010-01-01
期刊：
SKELETAL BIOLOGY AND MEDICINE
影响因子：
--
作者：
Keaveny, Tony M.
通讯作者：
Keaveny, Tony M.
影响因子：
2.4
作者：
Bessho, Masahiko;Ohnishi, Isao;Nakamura, Kozo
通讯作者：
Nakamura, Kozo