Longitudinal Associations Between Changes in Bone Mechanical Strength and Fracture Risk Estimated by FRAC.

IF 5.9 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Annabel R Bugbird, Danielle E Whittier, Lauren A Burt, Steven K Boyd
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引用次数: 0

Abstract

Introduction: Monitoring bone health for osteoporosis is typically based on measuring areal bone mineral density (aBMD). However, widely used fracture risk prediction tools are primarily driven by clinical risk factors and show limited sensitivity to underlying bone changes over time. This study evaluated the ability of the new Microarchitecture Fracture Risk Assessment Calculator (FRAC) to detect longitudinal changes in fracture risk in relation to bone quality.

Methods: Our study cohort included 601 participants (70.2% female) from a longitudinal population study. HR-pQCT scans of the distal radius and tibia were acquired at two visits, 3-10 years apart. The FRAC 5-year risk of major osteoporotic fracture (MOF) was calculated at both time points. Participants were divided into quartiles based on the absolute change in tibia bone strength between study visits to assess the model's sensitivity to changes in bone fragility. Differences between quartiles were assessed using a Mann-Whitney U test and the standardized response mean (SRM). Additionally, changes in fracture risk by decade, were analyzed to investigate age- and sex-specific trends in fracture risk.

Results: The average age of participants was 53.8 ± 15.4 years, with an average follow-up of 6.8 ± 1.8 years. The greatest absolute annualized changes in FRAC risk occurred in individuals with the largest differences in bone strength (SRM = 0.73-0.78), while the least change was observed in individuals with minimal changes (SRM = 0.07-0.21). Age- and sex-specific trends aligned with previously established patterns of bone aging, showing the greatest annualized changes in fracture risk in menopausal females (40-60 years) and older adults (70+ years).

Conclusion: We demonstrated FRAC is sensitive to changes in fracture risk driven by declines in bone quality in aging adults. These results suggest FRAC is well suited for tracking fracture prediction longitudinally and has potential to monitor osteoporosis disease progression and treatment response.

骨机械强度变化与FRAC估计的骨折风险之间的纵向关联。
骨质疏松症的骨健康监测通常基于测量面骨矿物质密度(aBMD)。然而,广泛使用的骨折风险预测工具主要由临床危险因素驱动,对潜在的骨变化的敏感性有限。本研究评估了新型微架构骨折风险评估计算器(FRAC)检测骨折风险与骨质量相关的纵向变化的能力。方法:我们的研究队列包括来自纵向人群研究的601名参与者(70.2%为女性)。HR-pQCT扫描桡骨远端和胫骨在两次访问中获得,间隔3-10年。在两个时间点计算FRAC 5年主要骨质疏松性骨折(MOF)的风险。根据研究访问期间胫骨强度的绝对变化将参与者分为四分位数,以评估模型对骨脆性变化的敏感性。采用Mann-Whitney U检验和标准化反应均值(SRM)评估四分位数之间的差异。此外,研究人员还分析了不同年龄和性别的骨折风险变化趋势。结果:参与者平均年龄为53.8±15.4岁,平均随访时间为6.8±1.8年。骨强度差异最大的个体(SRM = 0.73-0.78) FRAC风险的年化绝对变化最大,而变化最小的个体(SRM = 0.07-0.21) FRAC风险的年化绝对变化最小。年龄和性别特异性趋势与先前建立的骨老化模式一致,显示绝经期女性(40-60岁)和老年人(70岁以上)骨折风险的年化变化最大。结论:我们证明了FRAC对老年人骨质量下降导致的骨折风险变化敏感。这些结果表明FRAC非常适合纵向跟踪骨折预测,并具有监测骨质疏松症进展和治疗反应的潜力。
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来源期刊
Journal of Bone and Mineral Research
Journal of Bone and Mineral Research 医学-内分泌学与代谢
CiteScore
11.30
自引率
6.50%
发文量
257
审稿时长
2 months
期刊介绍: The Journal of Bone and Mineral Research (JBMR) publishes highly impactful original manuscripts, reviews, and special articles on basic, translational and clinical investigations relevant to the musculoskeletal system and mineral metabolism. Specifically, the journal is interested in original research on the biology and physiology of skeletal tissues, interdisciplinary research spanning the musculoskeletal and other systems, including but not limited to immunology, hematology, energy metabolism, cancer biology, and neurology, and systems biology topics using large scale “-omics” approaches. The journal welcomes clinical research on the pathophysiology, treatment and prevention of osteoporosis and fractures, as well as sarcopenia, disorders of bone and mineral metabolism, and rare or genetically determined bone diseases.
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