Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: The EPIDOS study
Different morphometric and densitometric parameters predict cervical and trochanteric hip fracture: The EPIDOS study
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DOI：
10.1359/jbmr.1997.12.11.1895
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发表时间：
1997-11-01
影响因子：
6.2
通讯作者：
Delmas, PD
中科院分区：
文献类型：
--
作者：
Duboeuf, F;Hans, D;Delmas, PD
我们使用实验软件在双能 X 射线骨密度扫描中测量股骨颈下部和上部特定区域的髋轴长度 (HAL) 和骨矿物质密度 (BMD)，为了确定这些参数是否是髋部骨折类型的显着预测因子，我们测量了 EPIDOS 前瞻性队列中的 167 名健康女性（对照）、24 名股骨粗隆女性和 42 名颈椎髋部骨折女性。在法国五个中心（亚眠、伊永、蒙彼利埃、巴黎、图卢兹）对 7575 名 75-95 岁的居家老年妇女进行髋部骨折危险因素的前瞻性研究，对骨折发生前基线时获得的数据进行测量，在颈椎骨折组中，HAL 显着长于对照组（94.2 vs 92.3，p = 0.03），并且根据年龄调整相关优势比（OR），体重和总股骨颈 BMD 显着（OR = 1.64，95% 置信区间 [CI] 1.06-2.55），相比之下，股骨粗隆骨折组中 HAL 与对照组无显着差异，股骨颈直径不是骨折的预测因子，股骨粗隆骨折组上、下股骨颈 BMD 低于对照组，两项测量均预测转子股骨颈相比之下，仅测量股骨颈上部可增强颈股骨颈骨折的预测（OR = 2.79 vs，全股骨颈为 1.97），而下部 BMD 与对照组没有差异，髋轴长度是股骨颈骨折的预测因子，股骨颈 BMD 分布在颈椎骨折和转子骨折之间是不同的，这些结果支持两种类型髋部之间存在不同病理生理机制的假设骨折。
We used an experimental software measuring the hip axis length (HAL) and bone mineral density (BMD) in specific regions of the lower and upper part of the femoral neck on dual-energy X-ray absorptiometry scans, To determine whether these parameters were significant predictors of the type of hip fracture, we measured 167 healthy women (controls), 24 women with trochanteric, and 42 women with cervical hip fractures within the EPIDOS prospective cohort, EPIDOS is a multicenter prospective study on risk factors for hip fracture performed in 7575 elderly women living at home, aged 75-95 and conducted in five French centers (Amiens, I;yon, Montpellier, Paris, Toulouse), Measurements were performed on data acquired at baseline before the occurrence of fracture, In the cervical fracture group, HAL was significantly longer than in controls (94.2 vs, 92.3, p = 0.03), and the associated odds ratio (OR) adjusted for age, weight, and total femoral neck BMD was significant (OR = 1.64, 95% confidence interval [CI] 1.06-2.55), In contrast, HAL was not significantly different from controls in the trochanteric fracture group, Femoral neck diameter,vas not a predictor of fracture, The upper and lo,ver femoral neck BMD was lower in the trochanteric fracture group than in controls, and both measurements predicted trochanteric femoral neck fracture, In contrast, the prediction of cervical femoral neck fracture was enhanced by measuring only the upper part of the femoral neck (OR = 2.79 vs, 1.97 for the total femoral neck) while BMD of the lower part was not different from controls, Hip axis length is a predictor of femoral neck fracture, Femoral neck BMD distribution is different between cervical and trochanteric fractures, These results support the hypothesis of a different pathophysiological mechanism between the two types of hip fractures.