Contribution of hip strength indices to hip fracture risk in elderly men and women
Contribution of hip strength indices to hip fracture risk in elderly men and women
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DOI：
10.1359/jbmr.050519
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发表时间：
2005-10-01
影响因子：
6.2
通讯作者：
Eisman, JA
中科院分区：
文献类型：
--
作者：
Ahlborg, HG;Nguyen, ND;Eisman, JA
在这项前瞻性病例对照研究中，股骨颈直径、横截面惯性矩或截面模量是校正BMD后髋部骨折风险的独立预测因子。然而，这些指标中的每一个对髋部骨折预测的贡献是适度的存在BMD.Introduction：髋部骨折预测的髋部强度的措施的相对贡献是不清楚的。本研究的目的是表征髋关节强度指数和髋部骨折的风险之间的关联，在老年男性和women.Materials和方法：71名女性和25名男性>= 60岁，谁持续髋部骨折在1989年至2003年的研究期间，从前瞻性的，以人口为基础的杜博骨质疏松症流行病学研究。这些骨折病例按年龄和性别以1：2的比例与非骨折个体随机匹配。在骨折事件发生前，通过DXA（Lunar DPX-L）测量股骨颈的BMD。通过使用髋关节强度分析软件对图像文件进行再分析，估计髋关节强度指标，包括股骨颈直径（FND）、横截面惯性矩（CSMI）和截面模量（Z）。（OR，1.6; 95% CI，1.0，2.7）、较低CSMI（OR，1.8; 95% CI，1.0，3.2）或Z（OR，1.6; 95% CI，1.1，5.1）。在男性中，这些髋关节强度指数都不是骨折风险的重要预测因素。然而，使用女性的结果作为先验分布，估计FND（OR，1.5; 95%CI，1.0，2.3）、CSMI（OR，1.6; 95%CI，1.0，2.5）或Z（OR，2.3; 95%CI，1.4，3.9）的BMD调整OR均与男性髋部骨折风险显著相关。在逻辑回归模型中，骨密度单独占32%和16%的女性和男性的骨折倾向的方差，分别。在模型中加入FND、CSMI和Z值后，FND、CSMI和Z值分别增加了34%和19%。结论：FND、CSMI和Z值均为女性和男性髋部骨折的独立危险因素。然而，这些措施的贡献髋部骨折的预测和以上骨密度可能是适度的。
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.