Kara B. Anderson, Mohammadreza Mohebbi, Monica C. Tembo, Pamela Rufus-Membere, Natalie K. Hyde, Julie A. Pasco, Mark A. Kotowicz, Kara L. Holloway-Kew
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Low-trauma incident fractures were identified radiologically. Participants were followed from baseline to first fracture, death, or end of follow-up period (31/12/16) (13,487 person-years follow-up). Time-updating Cox-proportional hazards modelling investigated associations between HSA parameters and fracture.</p><h3>Results</h3><p>Three hundred thirty-five participants reported fractures (rate: 24.99/1000 person-years [95% CI 22.46–27.80]). Higher NN BMD (HR:0.12, 95% CI:0.05–0.29), cross-sectional area (CSA) (0.37, 0.26–0.52), cross-sectional moment of inertia (CSMI) (0.66, 0.50–0.89), section modulus (SM) (0.40, 0.24–0.68) and cortical thickness (CT) (0.00, 0.00–0.01 due to rounding) were associated with decreased risk. IT BMD (0.08, 0.04–0.20), CSA (0.58, 0.49–0.69), CSMI (0.90, 0.85–0.94), and SM (0.69, 0.59–0.81) were similarly associated. Decreased risk was observed at increased values of S BMD (0.20, 0.10-0.38), CSA (0.60, 0.47–0.76), SM (0.60, 0.43–0.83), and CT (0.03, 0.01–0.14). Higher S endocortical diameter (1.81, 1.29–2.53), and buckling ratio (BR) at all sites (NN: 1.07, 1.04-1.11; IT: 1.08, 1.05–1.11, S: 1.31, 1.19–1.46) were associated with increased risk. After adjustment for total hip BMD, the associations with BR at the shaft (1.14, 1.00–1.30) were sustained. Other associations were attenuated.</p><h3>Conclusion</h3><p>A greater shaft buckling ratio was associated with an increased risk for fracture, independent of total hip BMD.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hip structure and incident fracture: a time-updating survival analysis over 20 years of data from the Geelong Osteoporosis Study\",\"authors\":\"Kara B. Anderson, Mohammadreza Mohebbi, Monica C. Tembo, Pamela Rufus-Membere, Natalie K. Hyde, Julie A. Pasco, Mark A. Kotowicz, Kara L. 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Participants were followed from baseline to first fracture, death, or end of follow-up period (31/12/16) (13,487 person-years follow-up). Time-updating Cox-proportional hazards modelling investigated associations between HSA parameters and fracture.</p><h3>Results</h3><p>Three hundred thirty-five participants reported fractures (rate: 24.99/1000 person-years [95% CI 22.46–27.80]). Higher NN BMD (HR:0.12, 95% CI:0.05–0.29), cross-sectional area (CSA) (0.37, 0.26–0.52), cross-sectional moment of inertia (CSMI) (0.66, 0.50–0.89), section modulus (SM) (0.40, 0.24–0.68) and cortical thickness (CT) (0.00, 0.00–0.01 due to rounding) were associated with decreased risk. IT BMD (0.08, 0.04–0.20), CSA (0.58, 0.49–0.69), CSMI (0.90, 0.85–0.94), and SM (0.69, 0.59–0.81) were similarly associated. Decreased risk was observed at increased values of S BMD (0.20, 0.10-0.38), CSA (0.60, 0.47–0.76), SM (0.60, 0.43–0.83), and CT (0.03, 0.01–0.14). 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引用次数: 0
摘要
目的髋关节结构分析（HSA）使用双X射线吸收测量（DXA）髋关节扫描来计算窄颈（NN）、转子间（IT）和轴（S）的几何形状，这可以补充骨矿物质密度（BMD），从而评估骨折风险。我们的目的是确定 HSA 参数是否与骨折有关。方法参与者为吉隆骨质疏松症研究中的女性（n = 986，年龄 40-94 岁）。HSA 根据 Lunar DPX-L 扫描结果计算得出。低创伤事故骨折通过放射学方法确定。对参与者进行了从基线到首次骨折、死亡或随访期结束（31/12/16）的随访（13,487人/年）。结果335名参与者报告了骨折（骨折率：24.99/1000人年 [95% CI 22.46-27.80]）。较高的 NN BMD（HR：0.12，95% CI：0.05-0.29）、横截面积（CSA）（0.37，0.26-0.52）、横截面惯性矩（CSMI）（0.66，0.50-0.89）、截面模量（SM）（0.40，0.24-0.68）和皮质厚度（CT）（0.00，0.00-0.01，因四舍五入）与风险降低有关。IT BMD (0.08，0.04-0.20)、CSA (0.58，0.49-0.69)、CSMI (0.90，0.85-0.94) 和 SM (0.69，0.59-0.81) 同样与风险降低有关。当 S BMD（0.20，0.10-0.38）、CSA（0.60，0.47-0.76）、SM（0.60，0.43-0.83）和 CT（0.03，0.01-0.14）值增加时，观察到风险降低。所有部位（NN：1.07，1.04-1.11；IT：1.08，1.05-1.11；S：1.31，1.19-1.46）较高的 S 内径（1.81，1.29-2.53）和屈曲比（BR）与风险增加有关。对全髋关节 BMD 进行调整后，轴部 BR（1.14，1.00-1.30）的相关性保持不变。结论 轴屈曲比越大，骨折风险越高，与总髋关节 BMD 无关。
Hip structure and incident fracture: a time-updating survival analysis over 20 years of data from the Geelong Osteoporosis Study
Summary
Hip structural analysis parameters are associated with risk of fracture in women across a long follow-up period, with buckling ratio persisting independent of total hip BMD.
Purpose
Hip structural analysis (HSA) uses dual X-ray absorptiometry (DXA) hip scans to calculate geometries of narrow neck (NN), intertrochanter (IT), and shaft (S), which may complement bone mineral density (BMD) for assessing fracture risk. We aimed to determine whether HSA parameters were associated with fracture.
Methods
Participants were women (n = 986, ages 40–94 year) from the Geelong Osteoporosis Study. HSA was calculated from Lunar DPX-L scans. Low-trauma incident fractures were identified radiologically. Participants were followed from baseline to first fracture, death, or end of follow-up period (31/12/16) (13,487 person-years follow-up). Time-updating Cox-proportional hazards modelling investigated associations between HSA parameters and fracture.
Results
Three hundred thirty-five participants reported fractures (rate: 24.99/1000 person-years [95% CI 22.46–27.80]). Higher NN BMD (HR:0.12, 95% CI:0.05–0.29), cross-sectional area (CSA) (0.37, 0.26–0.52), cross-sectional moment of inertia (CSMI) (0.66, 0.50–0.89), section modulus (SM) (0.40, 0.24–0.68) and cortical thickness (CT) (0.00, 0.00–0.01 due to rounding) were associated with decreased risk. IT BMD (0.08, 0.04–0.20), CSA (0.58, 0.49–0.69), CSMI (0.90, 0.85–0.94), and SM (0.69, 0.59–0.81) were similarly associated. Decreased risk was observed at increased values of S BMD (0.20, 0.10-0.38), CSA (0.60, 0.47–0.76), SM (0.60, 0.43–0.83), and CT (0.03, 0.01–0.14). Higher S endocortical diameter (1.81, 1.29–2.53), and buckling ratio (BR) at all sites (NN: 1.07, 1.04-1.11; IT: 1.08, 1.05–1.11, S: 1.31, 1.19–1.46) were associated with increased risk. After adjustment for total hip BMD, the associations with BR at the shaft (1.14, 1.00–1.30) were sustained. Other associations were attenuated.
Conclusion
A greater shaft buckling ratio was associated with an increased risk for fracture, independent of total hip BMD.
期刊介绍：
Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.
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