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Femoral neck bone loss predicts fracture risk independent of baseline BMD.
J Bone Miner Res 2005; 20(7):1195-201JB

Abstract

Whereas low BMD is known to be a risk factor for fracture, it is not clear whether loss of BMD is also a risk factor. In elderly women, greater loss of BMD at the femoral neck was associated with increased risk of fracture, independent of baseline BMD and age.

INTRODUCTION

Baseline measurement of BMD predicts fracture risk. However, it is not clear whether short-term bone loss is an independent risk factor for fractures. This study was designed to investigate the relationship between changes in BMD and fracture risk in elderly women in the general population.

MATERIALS AND METHODS

A total of 966 women > or = 60 years of age (mean, 70 +/- 6.7 [SD] years), who had been followed for an average of 10.7 years, were studied. Atraumatic fracture of the proximal femur (hip), symptomatic vertebral fracture, and other major fractures, excluding pathological fractures or those resulting from severe trauma, were recorded and confirmed by radiographs. Femoral neck and lumbar spine BMD was measured by DXA.

RESULTS

During the follow-up period, 224 had sustained a fracture (including 43 hip, 71 symptomatic vertebrae, 37 proximal humerus, 46 forearm and wrist, and 27 rib and pelvis fractures). The annual rate of change in BMD in fracture women (-2.1 +/- 4.2%) was significantly higher than that in nonfracture women (-0.8 +/- 2.8%; p = 0.005). In the multivariable Cox's proportional hazards analysis, the following factors were significant predictors of fracture risk: femoral neck bone loss (relative hazard [RH], 1.4; 95% CI, 1.1-1.8 per 5% loss), baseline femoral neck BMD (RH, 2.0; 95% CI, 1.7-2.7 per SD), and advancing age (RH, 1.2; 95% CI, 1.1-1.4). The proportion of fractures attributable to the three factors was 45%. For hip fracture, the attributable risk fraction was approximately 90%.

CONCLUSION

Bone loss at the femoral neck is a predictor of fracture risk in elderly women, independent of baseline BMD and age.

Authors+Show Affiliations

Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent's Hospital, Sydney, Australia. t.nguyen@garvan.org.auNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15940372

Citation

Nguyen, Tuan V., et al. "Femoral Neck Bone Loss Predicts Fracture Risk Independent of Baseline BMD." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 7, 2005, pp. 1195-201.
Nguyen TV, Center JR, Eisman JA. Femoral neck bone loss predicts fracture risk independent of baseline BMD. J Bone Miner Res. 2005;20(7):1195-201.
Nguyen, T. V., Center, J. R., & Eisman, J. A. (2005). Femoral neck bone loss predicts fracture risk independent of baseline BMD. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(7), pp. 1195-201.
Nguyen TV, Center JR, Eisman JA. Femoral Neck Bone Loss Predicts Fracture Risk Independent of Baseline BMD. J Bone Miner Res. 2005;20(7):1195-201. PubMed PMID: 15940372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Femoral neck bone loss predicts fracture risk independent of baseline BMD. AU - Nguyen,Tuan V, AU - Center,Jacqueline R, AU - Eisman,John A, Y1 - 2005/02/21/ PY - 2004/06/24/received PY - 2004/12/14/revised PY - 2005/02/18/accepted PY - 2005/6/9/pubmed PY - 2005/9/21/medline PY - 2005/6/9/entrez SP - 1195 EP - 201 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 20 IS - 7 N2 - UNLABELLED: Whereas low BMD is known to be a risk factor for fracture, it is not clear whether loss of BMD is also a risk factor. In elderly women, greater loss of BMD at the femoral neck was associated with increased risk of fracture, independent of baseline BMD and age. INTRODUCTION: Baseline measurement of BMD predicts fracture risk. However, it is not clear whether short-term bone loss is an independent risk factor for fractures. This study was designed to investigate the relationship between changes in BMD and fracture risk in elderly women in the general population. MATERIALS AND METHODS: A total of 966 women > or = 60 years of age (mean, 70 +/- 6.7 [SD] years), who had been followed for an average of 10.7 years, were studied. Atraumatic fracture of the proximal femur (hip), symptomatic vertebral fracture, and other major fractures, excluding pathological fractures or those resulting from severe trauma, were recorded and confirmed by radiographs. Femoral neck and lumbar spine BMD was measured by DXA. RESULTS: During the follow-up period, 224 had sustained a fracture (including 43 hip, 71 symptomatic vertebrae, 37 proximal humerus, 46 forearm and wrist, and 27 rib and pelvis fractures). The annual rate of change in BMD in fracture women (-2.1 +/- 4.2%) was significantly higher than that in nonfracture women (-0.8 +/- 2.8%; p = 0.005). In the multivariable Cox's proportional hazards analysis, the following factors were significant predictors of fracture risk: femoral neck bone loss (relative hazard [RH], 1.4; 95% CI, 1.1-1.8 per 5% loss), baseline femoral neck BMD (RH, 2.0; 95% CI, 1.7-2.7 per SD), and advancing age (RH, 1.2; 95% CI, 1.1-1.4). The proportion of fractures attributable to the three factors was 45%. For hip fracture, the attributable risk fraction was approximately 90%. CONCLUSION: Bone loss at the femoral neck is a predictor of fracture risk in elderly women, independent of baseline BMD and age. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15940372/Femoral_neck_bone_loss_predicts_fracture_risk_independent_of_baseline_BMD_ L2 - https://doi.org/10.1359/JBMR.050215 DB - PRIME DP - Unbound Medicine ER -