Geometry of proximal femur in the prediction of hip fracture in osteoporotic women
Geometry of proximal femur in the prediction of hip fracture in osteoporotic women
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DOI：
10.1259/bjr.72.860.10624337
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发表时间：
1999-08-01
影响因子：
2.6
通讯作者：
Malavolta, N
中科院分区：
文献类型：
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作者：
Gnudi, S;Ripamonti, C;Malavolta, N
对 111 名患有髋部骨折的白人绝经后妇女和 329 名健康对照进行了研究，以确定股骨近端几何形状是否可以预测老年妇女的髋部骨折并提高股骨颈骨矿物质密度 (BMD) 的判别能力。所有受试者均接受髋部双X射线光子吸收测定法（DXA），测量股骨颈BMD、髋轴长度、股骨颈宽度和股骨颈-干角。骨折受试者的股骨颈 BMD 较低，髋轴长度较长，颈干角更外翻。髋轴长度与颈干角、股骨颈宽度和年龄显着相关。颈干角度与年龄之间没有发现显着相关性。在标准化逻辑回归中，在校正年龄、体重和股骨颈 BMD 后，髋轴长度和颈干角独立于 BMD 预测骨折。在校正所有潜在的混杂因素后，股骨颈 BMD 显着区分骨折受试者。同时包含一个股骨几何参数和颈部 BMD 的逻辑模型的判别效果明显优于包含相同变量作为单一预测变量的逻辑模型。我们的数据表明，髋轴长度可能在骨折风险中发挥作用，并且支持颈干角度也具有类似的作用。股骨近端几何测量和股骨颈 BMD 的结合提高了每次测量的判别能力。
111 White post-menopausal women with hip fracture and 329 healthy controls were studied in order to determine whether proximal femur geometry predicts hip fracture and improves the discriminant ability of femoral neck bone mineral density (BMD) in elderly women. All subjects underwent dual X-ray photon absorptiometry (DXA) of the hip from which the femoral neck BMD, hip axis length, femoral neck width and femoral neck-shaft angle were measured. Fractured subjects had a lower femoral neck BMD, a longer hip axis length and a more valgus neck-shaft angle. The hip axis length correlated significantly with neck-shaft angle, femoral neck width and age. No significant correlation was found between neck-shaft angle and age. On standardized logistic regression, the hip axis length and the neck-shaft angle predicted fracture independently of BMD after correction for age, weight and femoral neck BMD. The femoral neck BMD significantly discriminated fractured subjects after correction for all potential confounders. The logistic models containing simultaneously one femoral geometric parameter and the neck BMD discriminated significantly better than those containing the same variables as single predictor. Our data suggest that hip axis length may play a role in fracture risk and supports a similar role for neck-shaft angle. Combining proximal femur geometric measurements and femoral neck BMD improved the discriminant ability of each measurement.