K Huininga, F Koromani, M C Zillikens, E F S van Velsen, F Rivadeneira
{"title":"利用3D-shaper®实现的dxa衍生的3d建模，在基于人群的环境中评估骨折风险。","authors":"K Huininga, F Koromani, M C Zillikens, E F S van Velsen, F Rivadeneira","doi":"10.1093/jbmr/zjaf120","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>3D-modeling of hip DXA scans has been proposed to partition BMD into cortical surface (csBMD) and trabecular \"volumetric\" (tvBMD). We assessed in a population-based cohort whether such partitioning contributes to fracture risk assessment compared to aBMD alone.</p><p><strong>Methods: </strong>Participants (N = 4908) from the Rotterdam Study comprised 56% women, mean age 67.4 (SD = 10.1) years. Hip DXA scans were analyzed with enCore (GE Lunar) and 3D Shaper software. Pearson partial correlation was calculated between aBMD, csBMD and tvBMD at the total hip, femoral neck and trochanter. Incident fractures were collected from GP or hospital records. During a mean follow-up of 6.8 (SD = 2.5) years, 171 sustained a hip fracture, and 1019 any-type fractures. Fracture risk estimates were determined as hazard ratios (HR) per SD decrease in BMD, from Cox-regression adjusted for multiple confounders.</p><p><strong>Results: </strong>High correlation (r= > 0.81; p < .001) was observed between aBMD and the modeled 3D parameters; also, between csBMD and tvBMD (r = 0.85; p < .001 at total hip). Lower aBMD was associated with higher incidence of any-type (HR = 1.60, 95%CI 1.43-1.78) and hip (HR = 2.46, 95%CI 1.90-3.17) fracture; lower csBMD with increased risk of any-type (HR = 1.44, 95%CI 1.30-1.60) and hip (csBMD HR = 1.76, 95%CI 1.39-2.23) fracture, and tvBMD with increased risk of any-type (HR = 1.62, 95%CI 1.45-1.80) and hip fracture (HR = 2.44, 95%CI 1.88-3.15). Inclusion of aBMD in models with tvBMD or csBMD resulted in high multicollinearity and unreliable coefficient parameters (VIF > 5). The effect of csBMD was largely attenuated after inclusion of tvBMD in the same model for both any-type (csBMD HR = 0.96, 95%CI 0.81-1.13; tvBMD HR = 1.67, 95%CI 1.41-1.98) and hip (csBMD HR = 0.83, 95%CI 0.58-1.21, tvBMD HR = 2.82, 95%CI 1.94-4.10) fractures. Similar results were observed at the neck and intertrochanteric regions.</p><p><strong>Conclusions: </strong>DXA-derived 3D modeled parameters are highly correlated to aBMD and do not provide additional value for the estimation of fracture risk beyond aBMD alone.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":5.9000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of DXA-derived 3D-modeling, as implemented by 3D-shaper®, for the assessment of fracture risk in a population-based setting.\",\"authors\":\"K Huininga, F Koromani, M C Zillikens, E F S van Velsen, F Rivadeneira\",\"doi\":\"10.1093/jbmr/zjaf120\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>3D-modeling of hip DXA scans has been proposed to partition BMD into cortical surface (csBMD) and trabecular \\\"volumetric\\\" (tvBMD). We assessed in a population-based cohort whether such partitioning contributes to fracture risk assessment compared to aBMD alone.</p><p><strong>Methods: </strong>Participants (N = 4908) from the Rotterdam Study comprised 56% women, mean age 67.4 (SD = 10.1) years. Hip DXA scans were analyzed with enCore (GE Lunar) and 3D Shaper software. Pearson partial correlation was calculated between aBMD, csBMD and tvBMD at the total hip, femoral neck and trochanter. Incident fractures were collected from GP or hospital records. During a mean follow-up of 6.8 (SD = 2.5) years, 171 sustained a hip fracture, and 1019 any-type fractures. Fracture risk estimates were determined as hazard ratios (HR) per SD decrease in BMD, from Cox-regression adjusted for multiple confounders.</p><p><strong>Results: </strong>High correlation (r= > 0.81; p < .001) was observed between aBMD and the modeled 3D parameters; also, between csBMD and tvBMD (r = 0.85; p < .001 at total hip). Lower aBMD was associated with higher incidence of any-type (HR = 1.60, 95%CI 1.43-1.78) and hip (HR = 2.46, 95%CI 1.90-3.17) fracture; lower csBMD with increased risk of any-type (HR = 1.44, 95%CI 1.30-1.60) and hip (csBMD HR = 1.76, 95%CI 1.39-2.23) fracture, and tvBMD with increased risk of any-type (HR = 1.62, 95%CI 1.45-1.80) and hip fracture (HR = 2.44, 95%CI 1.88-3.15). Inclusion of aBMD in models with tvBMD or csBMD resulted in high multicollinearity and unreliable coefficient parameters (VIF > 5). The effect of csBMD was largely attenuated after inclusion of tvBMD in the same model for both any-type (csBMD HR = 0.96, 95%CI 0.81-1.13; tvBMD HR = 1.67, 95%CI 1.41-1.98) and hip (csBMD HR = 0.83, 95%CI 0.58-1.21, tvBMD HR = 2.82, 95%CI 1.94-4.10) fractures. Similar results were observed at the neck and intertrochanteric regions.</p><p><strong>Conclusions: </strong>DXA-derived 3D modeled parameters are highly correlated to aBMD and do not provide additional value for the estimation of fracture risk beyond aBMD alone.</p>\",\"PeriodicalId\":185,\"journal\":{\"name\":\"Journal of Bone and Mineral Research\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2025-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Bone and Mineral Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jbmr/zjaf120\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Bone and Mineral Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jbmr/zjaf120","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Use of DXA-derived 3D-modeling, as implemented by 3D-shaper®, for the assessment of fracture risk in a population-based setting.
Introduction: 3D-modeling of hip DXA scans has been proposed to partition BMD into cortical surface (csBMD) and trabecular "volumetric" (tvBMD). We assessed in a population-based cohort whether such partitioning contributes to fracture risk assessment compared to aBMD alone.
Methods: Participants (N = 4908) from the Rotterdam Study comprised 56% women, mean age 67.4 (SD = 10.1) years. Hip DXA scans were analyzed with enCore (GE Lunar) and 3D Shaper software. Pearson partial correlation was calculated between aBMD, csBMD and tvBMD at the total hip, femoral neck and trochanter. Incident fractures were collected from GP or hospital records. During a mean follow-up of 6.8 (SD = 2.5) years, 171 sustained a hip fracture, and 1019 any-type fractures. Fracture risk estimates were determined as hazard ratios (HR) per SD decrease in BMD, from Cox-regression adjusted for multiple confounders.
Results: High correlation (r= > 0.81; p < .001) was observed between aBMD and the modeled 3D parameters; also, between csBMD and tvBMD (r = 0.85; p < .001 at total hip). Lower aBMD was associated with higher incidence of any-type (HR = 1.60, 95%CI 1.43-1.78) and hip (HR = 2.46, 95%CI 1.90-3.17) fracture; lower csBMD with increased risk of any-type (HR = 1.44, 95%CI 1.30-1.60) and hip (csBMD HR = 1.76, 95%CI 1.39-2.23) fracture, and tvBMD with increased risk of any-type (HR = 1.62, 95%CI 1.45-1.80) and hip fracture (HR = 2.44, 95%CI 1.88-3.15). Inclusion of aBMD in models with tvBMD or csBMD resulted in high multicollinearity and unreliable coefficient parameters (VIF > 5). The effect of csBMD was largely attenuated after inclusion of tvBMD in the same model for both any-type (csBMD HR = 0.96, 95%CI 0.81-1.13; tvBMD HR = 1.67, 95%CI 1.41-1.98) and hip (csBMD HR = 0.83, 95%CI 0.58-1.21, tvBMD HR = 2.82, 95%CI 1.94-4.10) fractures. Similar results were observed at the neck and intertrochanteric regions.
Conclusions: DXA-derived 3D modeled parameters are highly correlated to aBMD and do not provide additional value for the estimation of fracture risk beyond aBMD alone.
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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