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Contribution of hip strength indices to hip fracture risk in elderly men and women.
J Bone Miner Res. 2005 Oct; 20(10):1820-7.JB

Abstract

In this prospective, case-control study, femoral neck diameter, cross-sectional moment of inertia, or section modulus was an independent predictor of hip fracture risk after adjustment for BMD. However, the contribution of each of these indices to hip fracture prediction was modest in the presence of BMD.

INTRODUCTION

The relative contribution of measures of hip strength to hip fracture prediction is unclear. This study was designed to characterize the association between hip strength indices and hip fracture risk in relation to BMD in elderly men and women.

MATERIALS AND METHODS

Seventy-one women and 25 men>or=60 years of age, who sustained a hip fracture during the study period of 1989-2003, were selected from the prospective, population-based Dubbo Osteoporosis Epidemiology Study. These fracture cases were randomly matched for age and sex in a 1:2 ratio with nonfracture individuals. BMD at the femoral neck was measured before the fracture event by DXA (Lunar DPX-L). Hip strength indices, including femoral neck diameter (FND), cross-sectional moment of inertia (CSMI), and section modulus (Z), were estimated by reanalysis of the image files using hip strength analysis software.

RESULTS

In women, after adjustment for BMD, increased risk of hip fracture was associated with smaller FND (OR, 1.6; 95% CI, 1.0, 2.7), lower CSMI (OR, 1.8; 95% CI, 1.0, 3.2), or Z (OR, 1.6; 95% CI, 1.1, 5.1). In men, none of these hip strength indices were significant predictors of fracture risk. However, using the results in women as a prior distribution, it was estimated that the BMD-adjusted OR for FND (OR, 1.5; 95% CI, 1.0, 2.3), CSMI (OR, 1.6; 95% CI, 1.0, 2.5), or Z (OR, 2.3; 95% CI, 1.4, 3.9) was each significantly associated with hip fracture risk in men. In the logistic regression model, BMD alone accounted for 32% and 16% of the variance of fracture liability in women and men, respectively. The addition of FND, CSMI, or Z to the model increased the respective variance proportion to 34% and 19%.

CONCLUSIONS

These data suggest that smaller FND and lower CSMI or Z is an independent risk factor for hip fracture in both women and men. However, the contribution of these measures to hip fracture prediction over and above BMD is likely modest.

Authors+Show Affiliations

Bone and Mineral Research Program, Garvan Institute of Medical Research, Sydney, Australia, and Department of Orthopaedics, Malmö University Hospital, Sweden. Henrik.Ahlborg@med.lu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16160739

Citation

Ahlborg, Henrik G., et al. "Contribution of Hip Strength Indices to Hip Fracture Risk in Elderly Men and Women." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 10, 2005, pp. 1820-7.
Ahlborg HG, Nguyen ND, Nguyen TV, et al. Contribution of hip strength indices to hip fracture risk in elderly men and women. J Bone Miner Res. 2005;20(10):1820-7.
Ahlborg, H. G., Nguyen, N. D., Nguyen, T. V., Center, J. R., & Eisman, J. A. (2005). Contribution of hip strength indices to hip fracture risk in elderly men and women. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(10), 1820-7.
Ahlborg HG, et al. Contribution of Hip Strength Indices to Hip Fracture Risk in Elderly Men and Women. J Bone Miner Res. 2005;20(10):1820-7. PubMed PMID: 16160739.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contribution of hip strength indices to hip fracture risk in elderly men and women. AU - Ahlborg,Henrik G, AU - Nguyen,Nguyen D, AU - Nguyen,Tuan V, AU - Center,Jacqueline R, AU - Eisman,John A, Y1 - 2005/05/31/ PY - 2004/08/24/received PY - 2005/04/21/revised PY - 2005/05/27/accepted PY - 2005/9/15/pubmed PY - 2006/3/8/medline PY - 2005/9/15/entrez SP - 1820 EP - 7 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 - 10 N2 - UNLABELLED: In this prospective, case-control study, femoral neck diameter, cross-sectional moment of inertia, or section modulus was an independent predictor of hip fracture risk after adjustment for BMD. However, the contribution of each of these indices to hip fracture prediction was modest in the presence of BMD. INTRODUCTION: The relative contribution of measures of hip strength to hip fracture prediction is unclear. This study was designed to characterize the association between hip strength indices and hip fracture risk in relation to BMD in elderly men and women. MATERIALS AND METHODS: Seventy-one women and 25 men>or=60 years of age, who sustained a hip fracture during the study period of 1989-2003, were selected from the prospective, population-based Dubbo Osteoporosis Epidemiology Study. These fracture cases were randomly matched for age and sex in a 1:2 ratio with nonfracture individuals. BMD at the femoral neck was measured before the fracture event by DXA (Lunar DPX-L). Hip strength indices, including femoral neck diameter (FND), cross-sectional moment of inertia (CSMI), and section modulus (Z), were estimated by reanalysis of the image files using hip strength analysis software. RESULTS: In women, after adjustment for BMD, increased risk of hip fracture was associated with smaller FND (OR, 1.6; 95% CI, 1.0, 2.7), lower CSMI (OR, 1.8; 95% CI, 1.0, 3.2), or Z (OR, 1.6; 95% CI, 1.1, 5.1). In men, none of these hip strength indices were significant predictors of fracture risk. However, using the results in women as a prior distribution, it was estimated that the BMD-adjusted OR for FND (OR, 1.5; 95% CI, 1.0, 2.3), CSMI (OR, 1.6; 95% CI, 1.0, 2.5), or Z (OR, 2.3; 95% CI, 1.4, 3.9) was each significantly associated with hip fracture risk in men. In the logistic regression model, BMD alone accounted for 32% and 16% of the variance of fracture liability in women and men, respectively. The addition of FND, CSMI, or Z to the model increased the respective variance proportion to 34% and 19%. CONCLUSIONS: These data suggest that smaller FND and lower CSMI or Z is an independent risk factor for hip fracture in both women and men. However, the contribution of these measures to hip fracture prediction over and above BMD is likely modest. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/16160739/Contribution_of_hip_strength_indices_to_hip_fracture_risk_in_elderly_men_and_women_ L2 - https://doi.org/10.1359/JBMR.050519 DB - PRIME DP - Unbound Medicine ER -