Association between the minimal model of hip structure and risk of hip fracture in Chinese adults.

Abstract

Background: Multiple studies have indicated that the minimal model of hip structure can enhance hip fracture risk assessment. This study aimed to investigate the independent association between minimal model variables and hip fracture risk in Han Chinese individuals.

Methods: This cross-sectional study included 937 Han Chinese patients (248 with hip fractures). Minimal model variables were calculated from the hip structural analysis, including bone mineral density (BMD), femoral neck width (FNW), and Delta and Sigma values.

Results: This study included 937 patients (293 men; mean age = 68.3 years). In logistic regression analyses, BMD increase (per 0.1 g/cm²) correlated with a 45% reduction in the hip fracture risk (odds ratio [OR] = 0.55; 95% confidence interval [CI]: 0.45-0.68) after adjusting for all covariates. However, FNW (per 0.1 cm) and Sigma (per 0.01 cm) and Delta values (per 0.01 cm) were associated with increased risks (OR = 1.28; 95% CI: 1.18-1.37; OR = 1.06; 95% CI: 1.03-1.09; OR = 1.06; 95% CI: 1.03-1.09, respectively). When the Delta was >0.17 cm, the risk of hip fracture rose considerably by 13% (OR = 1.13; 95% CI: 1.08-1.18) for every 0.01 cm that the Delta value increased. The area under the curve (AUC) for hip fracture prediction from BMD alone was significantl lower than those of minimal model (0.781 vs 0.838, p <0.05).

Conclusion: Large increases in FNW, Sigma and Delta values and notable declines in BMD were individually and significantly linked to a high hip fracture risk in Han Chinese adults. Our findings suggest that the minimal model of hip structure may improve hip fracture risk assessments.