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Association of High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) bone microarchitectural parameters with previous clinical fracture in older men: The Osteoporotic Fractures in Men (MrOS) study.
Bone. 2018 08; 113:49-56.BONE

Abstract

High-resolution peripheral quantitative computed tomography (HR-pQCT) assesses both volumetric bone mineral density (vBMD) and trabecular and cortical microarchitecture. However, studies of the association of HR-pQCT parameters with fracture history have been small, predominantly limited to postmenopausal women, often performed limited adjustment for potential confounders including for BMD, and infrequently assessed strength or failure measures. We used data from the Osteoporotic Fractures in Men (MrOS) study, a prospective cohort study of community-dwelling men aged ≥65 years, to evaluate the association of distal radius, proximal (diaphyseal) tibia and distal tibia HR-pQCT parameters measured at the Year 14 (Y14) study visit with prior clinical fracture. The primary HR-pQCT exposure variables were finite element analysis estimated failure loads (EFL) for each skeletal site; secondary exposure variables were total vBMD, total bone area, trabecular vBMD, trabecular bone area, trabecular thickness, trabecular number, cortical vBMD, cortical bone area, cortical thickness, and cortical porosity. Clinical fractures were ascertained from questionnaires administered every 4 months between MrOS study baseline and the Y14 visit and centrally adjudicated by masked review of radiographic reports. We used multivariate-adjusted logistic regression to estimate the odds of prior clinical fracture per 1 SD decrement for each Y14 HR-pQCT parameter. Three hundred forty-four (19.2%) of the 1794 men with available HR-pQCT measures had a confirmed clinical fracture between baseline and Y14. After multivariable adjustment, including for total hip areal BMD, decreased HR-pQCT finite element analysis EFL for each site was associated with significantly greater odds of prior confirmed clinical fracture and major osteoporotic fracture. Among other HR-pQCT parameters, decreased cortical area appeared to have the strongest independent association with prior clinical fracture. Future studies should explore associations of HR-pQCT parameters with specific fracture types and risk of incident fractures and the impact of age and sex on these relationships.

Authors+Show Affiliations

Geriatric Research Education & Clinical Center, Veterans Affairs Health Care System, Minneapolis, MN, USA; Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. Electronic address: howard.fink@va.gov.Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.Park Nicollet Institute, Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

29751130

Citation

Fink, Howard A., et al. "Association of High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) Bone Microarchitectural Parameters With Previous Clinical Fracture in Older Men: the Osteoporotic Fractures in Men (MrOS) Study." Bone, vol. 113, 2018, pp. 49-56.
Fink HA, Langsetmo L, Vo TN, et al. Association of High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) bone microarchitectural parameters with previous clinical fracture in older men: The Osteoporotic Fractures in Men (MrOS) study. Bone. 2018;113:49-56.
Fink, H. A., Langsetmo, L., Vo, T. N., Orwoll, E. S., Schousboe, J. T., & Ensrud, K. E. (2018). Association of High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) bone microarchitectural parameters with previous clinical fracture in older men: The Osteoporotic Fractures in Men (MrOS) study. Bone, 113, 49-56. https://doi.org/10.1016/j.bone.2018.05.005
Fink HA, et al. Association of High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) Bone Microarchitectural Parameters With Previous Clinical Fracture in Older Men: the Osteoporotic Fractures in Men (MrOS) Study. Bone. 2018;113:49-56. PubMed PMID: 29751130.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) bone microarchitectural parameters with previous clinical fracture in older men: The Osteoporotic Fractures in Men (MrOS) study. AU - Fink,Howard A, AU - Langsetmo,Lisa, AU - Vo,Tien N, AU - Orwoll,Eric S, AU - Schousboe,John T, AU - Ensrud,Kristine E, AU - ,, Y1 - 2018/05/08/ PY - 2018/02/08/received PY - 2018/05/02/revised PY - 2018/05/07/accepted PY - 2018/5/12/pubmed PY - 2019/5/15/medline PY - 2018/5/12/entrez KW - Aged KW - Bone microarchitecture KW - Fracture KW - Male KW - Radiology SP - 49 EP - 56 JF - Bone JO - Bone VL - 113 N2 - High-resolution peripheral quantitative computed tomography (HR-pQCT) assesses both volumetric bone mineral density (vBMD) and trabecular and cortical microarchitecture. However, studies of the association of HR-pQCT parameters with fracture history have been small, predominantly limited to postmenopausal women, often performed limited adjustment for potential confounders including for BMD, and infrequently assessed strength or failure measures. We used data from the Osteoporotic Fractures in Men (MrOS) study, a prospective cohort study of community-dwelling men aged ≥65 years, to evaluate the association of distal radius, proximal (diaphyseal) tibia and distal tibia HR-pQCT parameters measured at the Year 14 (Y14) study visit with prior clinical fracture. The primary HR-pQCT exposure variables were finite element analysis estimated failure loads (EFL) for each skeletal site; secondary exposure variables were total vBMD, total bone area, trabecular vBMD, trabecular bone area, trabecular thickness, trabecular number, cortical vBMD, cortical bone area, cortical thickness, and cortical porosity. Clinical fractures were ascertained from questionnaires administered every 4 months between MrOS study baseline and the Y14 visit and centrally adjudicated by masked review of radiographic reports. We used multivariate-adjusted logistic regression to estimate the odds of prior clinical fracture per 1 SD decrement for each Y14 HR-pQCT parameter. Three hundred forty-four (19.2%) of the 1794 men with available HR-pQCT measures had a confirmed clinical fracture between baseline and Y14. After multivariable adjustment, including for total hip areal BMD, decreased HR-pQCT finite element analysis EFL for each site was associated with significantly greater odds of prior confirmed clinical fracture and major osteoporotic fracture. Among other HR-pQCT parameters, decreased cortical area appeared to have the strongest independent association with prior clinical fracture. Future studies should explore associations of HR-pQCT parameters with specific fracture types and risk of incident fractures and the impact of age and sex on these relationships. SN - 1873-2763 UR - https://www.unboundmedicine.com/medline/citation/29751130/Association_of_High_resolution_Peripheral_Quantitative_Computed_Tomography__HR_pQCT__bone_microarchitectural_parameters_with_previous_clinical_fracture_in_older_men:_The_Osteoporotic_Fractures_in_Men__MrOS__study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S8756-3282(18)30184-4 DB - PRIME DP - Unbound Medicine ER -