Improving risk assessment: Hip geometry, bone mineral distribution and bone strength in hip fracture cases and controls. The EPOS study
Improving risk assessment: Hip geometry, bone mineral distribution and bone strength in hip fracture cases and controls. The EPOS study
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DOI：
10.1007/s198-002-8337-y
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发表时间：
2002-01-01
影响因子：
4
通讯作者：
Reeve, J
中科院分区：
文献类型：
--
作者：
Crabtree, NJ;Kroger, H;Reeve, J
髋关节几何形状和骨矿物质密度（BMD）先前已被证明与髋部骨折风险独立相关。我们的目的是确定髋关节几何数据在多大程度上改善了髋关节骨折的识别。获得股骨近端的月球笔形束扫描。来自800名60岁或以上女性对照的几何和密度值（来自欧洲前瞻性骨质疏松研究的参与者群体样本）。EPOS）与68例年龄在60岁以上的女性髋部骨折患者的数据进行了比较，这些患者在对侧髋部骨折后4周内进行了扫描。我们使用Lunar DPX“beta”版本的髋关节强度分析（HSA）和髋关节轴长度（HAL）应用于DPX（L）数据。压缩应力（Cstress），由HSA软件计算，作为大转子上典型跌倒的结果。HAL、体重指数（BMI：体重/身高）和年龄与股骨颈BMD（FN-BMD，g/cm（2））一起被认为是骨折的潜在预测因素。Logistic回归用于从FN-BMD生成骨折的预测因子。下一个年龄，Cstress（作为最具鉴别力的HSA衍生参数），HAL和BMI作为潜在的独立预测因子加入模型。没有必要在logistic模型中同时包括HAL和Cstress。因此，在不排除HAL测量缺失的受试者的情况下检查了整个数据集。通过比较受试者工作特征（ROC）曲线下面积（p
Hip geometry and bone mineral density (BMD) have previously been shown to relate independently to hip fracture risk. Our objective was to determine by how much hip geometric data improved the identification of hip fracture. Lunar pencil beam scans of the proximal femur were obtained. Geometric and densitometric values from 800 female controls aged 60 years or more (from population samples which were participants in the European Prospective Osteoporosis Study. EPOS) were compared with data from 68 female hip fracture patients aged over 60 years who were scanned within 4 weeks of a contralateral hip fracture. We used Lunar DPX 'beta' versions of hip strength analysis (HSA) and hip axis length (HAL) applied to DPX(L) data. Compressive stress (Cstress), calculated by the HSA software to occur as a result of a typical fall on the greater trochanter. HAL, body mass index (BMI: weight/(height)) and age were considered alongside femoral neck BMD (FN-BMD, g/cm(2)) as potential predictors of fracture. Logistic regression was used to generate predictors of fracture initially from FN-BMD. Next age, Cstress (as the most discriminating HSA-derived parameter), HAL and BMI were added to the model as potentially independent predictors. It was not necessary to include both HAL and Cstress in the logistic models. so the entire data set was examined without excluding the subjects missing HAL measurements. Cstress combined with age and BMI provided significantly better prediction of fracture than FN-BMD used alone as is current practice, judged by comparing areas under receiver operating characteristic (ROC) curves (p