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Differences in site-specific fracture risk among older women with discordant results for osteoporosis at hip and spine: study of osteoporotic fractures.
J Clin Densitom 2008 Apr-Jun; 11(2):250-9JC

Abstract

To examine the fracture pattern in older women whose bone mineral density (BMD) T-score criteria for osteoporosis at hip and spine disagree, hip and spine BMD were measured in Study of Osteoporotic Fractures participants using dual energy X-ray absorptiometry (DXA). Hip osteoporosis was defined as T-score <or=-2.5 at femoral neck or total hip, and spine osteoporosis as T-score <or=-2.5 at lumbar spine. Incident clinical fractures were self-reported and centrally adjudicated. Incident radiographic spine fractures were defined morphometrically. Compared to women with osteoporosis at neither hip nor spine, those osteoporotic only at hip had a 3.0-fold age- and weight-adjusted increased risk for hip fracture (95% confidence interval [CI]: 2.4-3.6), and smaller increases in risk of nonhip nonspine (hazard ratios [HR]=1.6), clinical spine (odds ratio [OR]=2.2), and radiographic spine fractures (OR=1.5). Women osteoporotic only at spine had a 2.8-fold increased odds of radiographic spine fracture (95% CI: 2.1-3.8), and smaller increases in risk of clinical spine (OR=1.4), nonhip nonspine (HR=1.6), and hip fractures (HR=1.2). Discordant BMD results predict different fracture patterns. DXA fracture risk estimation in these patients should be site specific. Women osteoporotic only at spine would not have been identified from hip BMD measurement alone, and may have a sufficiently high fracture risk to warrant preventive treatment.

Authors+Show Affiliations

Geriatric Research Education & Clinical Center, VA Medical Center, Minneapolis, MN 55417, USA. howard.fink@va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18296090

Citation

Fink, Howard A., et al. "Differences in Site-specific Fracture Risk Among Older Women With Discordant Results for Osteoporosis at Hip and Spine: Study of Osteoporotic Fractures." Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry, vol. 11, no. 2, 2008, pp. 250-9.
Fink HA, Harrison SL, Taylor BC, et al. Differences in site-specific fracture risk among older women with discordant results for osteoporosis at hip and spine: study of osteoporotic fractures. J Clin Densitom. 2008;11(2):250-9.
Fink, H. A., Harrison, S. L., Taylor, B. C., Cummings, S. R., Schousboe, J. T., Kuskowski, M. A., ... Ensrud, K. E. (2008). Differences in site-specific fracture risk among older women with discordant results for osteoporosis at hip and spine: study of osteoporotic fractures. Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry, 11(2), pp. 250-9. doi:10.1016/j.jocd.2007.12.018.
Fink HA, et al. Differences in Site-specific Fracture Risk Among Older Women With Discordant Results for Osteoporosis at Hip and Spine: Study of Osteoporotic Fractures. J Clin Densitom. 2008;11(2):250-9. PubMed PMID: 18296090.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in site-specific fracture risk among older women with discordant results for osteoporosis at hip and spine: study of osteoporotic fractures. AU - Fink,Howard A, AU - Harrison,Stephanie L, AU - Taylor,Brent C, AU - Cummings,Steven R, AU - Schousboe,John T, AU - Kuskowski,Michael A, AU - Stone,Katie L, AU - Ensrud,Kristine E, AU - ,, Y1 - 2008/02/25/ PY - 2007/08/10/received PY - 2007/12/20/revised PY - 2007/12/20/accepted PY - 2008/2/26/pubmed PY - 2008/10/29/medline PY - 2008/2/26/entrez SP - 250 EP - 9 JF - Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry JO - J Clin Densitom VL - 11 IS - 2 N2 - To examine the fracture pattern in older women whose bone mineral density (BMD) T-score criteria for osteoporosis at hip and spine disagree, hip and spine BMD were measured in Study of Osteoporotic Fractures participants using dual energy X-ray absorptiometry (DXA). Hip osteoporosis was defined as T-score <or=-2.5 at femoral neck or total hip, and spine osteoporosis as T-score <or=-2.5 at lumbar spine. Incident clinical fractures were self-reported and centrally adjudicated. Incident radiographic spine fractures were defined morphometrically. Compared to women with osteoporosis at neither hip nor spine, those osteoporotic only at hip had a 3.0-fold age- and weight-adjusted increased risk for hip fracture (95% confidence interval [CI]: 2.4-3.6), and smaller increases in risk of nonhip nonspine (hazard ratios [HR]=1.6), clinical spine (odds ratio [OR]=2.2), and radiographic spine fractures (OR=1.5). Women osteoporotic only at spine had a 2.8-fold increased odds of radiographic spine fracture (95% CI: 2.1-3.8), and smaller increases in risk of clinical spine (OR=1.4), nonhip nonspine (HR=1.6), and hip fractures (HR=1.2). Discordant BMD results predict different fracture patterns. DXA fracture risk estimation in these patients should be site specific. Women osteoporotic only at spine would not have been identified from hip BMD measurement alone, and may have a sufficiently high fracture risk to warrant preventive treatment. SN - 1094-6950 UR - https://www.unboundmedicine.com/medline/citation/18296090/Differences_in_site_specific_fracture_risk_among_older_women_with_discordant_results_for_osteoporosis_at_hip_and_spine:_study_of_osteoporotic_fractures_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1094-6950(07)00267-3 DB - PRIME DP - Unbound Medicine ER -