Hip structural geometry and incidence of hip fracture in postmenopausal women: what does it add to conventional bone mineral density?
Hip structural geometry and incidence of hip fracture in postmenopausal women: what does it add to conventional bone mineral density?
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DOI：
10.1007/s00198-009-1056-1
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发表时间：
2010-06
影响因子：
4
通讯作者：
Chen, Z.
中科院分区：
文献类型：
--
作者：
LaCroix, A. Z.;Beck, T. J.;Cauley, J. A.;Lewis, C. E.;Bassford, T.;Jackson, R.;Wu, G.;Chen, Z.
股骨粗隆间和股骨干双能X线骨密度仪（DXA）扫描测量股骨外径和屈曲比，预测绝经后女性髋部骨折的发生率。这些关联，独立于年龄，体型，临床危险因素，和传统的面积骨矿物质密度，表明髋关节几何形状在骨折病因中发挥作用，并可能有助于提高识别老年妇女骨折的高风险。本研究探讨了髋部几何参数是否能独立于体型、临床危险因素和常规股骨颈骨密度（aBMD）预测髋部骨折，以及是否能确定预测髋部骨折的汇总因素。我们研究了来自妇女健康倡议的10,290名绝经后妇女。8843例在随访至11年的随访期间保持无骨折，147例髋关节骨折，1,300例有其他临床骨折。髋关节结构分析软件测量骨横截面积，外径，截面模量，平均皮质厚度和屈曲比存档DXA扫描在三个髋关节区域：窄颈，转子间和骨干。使用考克斯比例风险模型估计单个参数和从所有15个参数的主成分分析中提取的复合因素的风险比。调整年龄、体型、临床危险因素和aBMD后，转子间和股骨干外径测量值仍然是髋部骨折的独立预测因素，转子间和股骨干的风险比分别增加1. 61（95% CI，1. 25 - 2. 08）和1. 36（95% CI，1. 06 - 1. 76）。平均屈曲比也能独立预测髋部骨折的发生率，转子间和股骨干的风险比分别为1.43（95%CI，1.10-1.87）和1.24（95%CI，1.00-1.55）。虽然从主成分分析中提取了两个复合因素，但在预测髋部骨折事件方面，两个因素都不上级这些单独的测量值。考虑临床危险因素和aBMD后，两个髋关节几何参数，转子间外径和屈曲比，可预测发生髋关节骨折。
Hip geometry measurements of outer diameter and buckling ratio at the intertrochanter and shaft of the hip dual energy X-ray absorptiometry (DXA) scan predicted incident hip fracture in postmenopausal women. These associations, independent of age, body size, clinical risk factors, and conventional areal bone mineral density, suggest hip geometry plays a role in fracture etiology and may aid in improving identification of older women at high fracture risk. This study examined whether hip geometry parameters predicted hip fracture independent of body size, clinical risk factors and conventional femoral neck bone mineral density (aBMD) and whether summary factors could be identified to predict hip fracture. We studied 10,290 postmenopausal women from the Women’s Health Initiative. Eight thousand eight hundred forty-three remained fracture free during follow-up to 11 years of follow-up, while 147 fractured their hip, and 1,300 had other clinical fractures. Hip structural analysis software measured bone cross-sectional area, outer diameter, section modulus, average cortical thickness and buckling ratio on archived DXA scans in three hip regions: narrow neck, intertrochanter and shaft. Hazard ratios were estimated using Cox proportional hazards models for individual parameters and for composite factors extracted from principal components analysis from all 15 parameters. After adjustment for age, body size, clinical risk factors and aBMD, intertrochanter and shaft outer diameter measurements remained independent predictors of hip fracture with hazard ratios for a one standard deviation increase of 1.61 (95% confidence interval (CI), 1.25–2.08) for the intertrochanter and 1.36 (95% CI, 1.06–1.76) for the shaft. Average buckling ratios also independently predicted incident hip fracture with hazard ratios of 1.43 (95% CI, 1.10–1.87) at the intertrochanter and 1.24 (95% CI, 1.00–1.55) at the shaft. Although two composite factors were extracted from principal components analysis, neither was superior to these individual measurements at predicting incident hip fracture. Two hip geometry parameters, intertrochanter outer diameter and buckling ratio, predict incident hip fracture after accounting for clinical risk factors and aBMD.
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影响因子：
6.2
作者：
Rivadeneira, Fernando;Zillikens, M. Carokf;Pols, Huibert A. P.
通讯作者：
Pols, Huibert A. P.
影响因子：
6.2
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影响因子：
56.9
作者：
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通讯作者：
HAYES, WC
影响因子：
168.9
作者：
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通讯作者：
Reeve, J
影响因子：
6.2
作者：
Johnell, O;Kanis, JA;Tenenhouse, A
通讯作者：
Tenenhouse, A