BMD at Multiple Sites and Risk of Fracture of Multiple Types: Long-Term Results From the Study of Osteoporotic Fractures

Abstract

In a large cohort of U.S. women aged 65 and older, we report the relationships of BMD measured at several sites, and subsequent fracture risk at multiple sites over >8 years of follow-up. Although we found almost all fracture types to be related to low BMD, the overall proportion of fractures attributable to low BMD is modest.Introduction: Although several studies have reported the relationship between bone mineral density (BMD) and subsequent fracture risk, most have been limited by short follow-up time, BMD measures at only one or two sites, or availability of data for only select fracture types. Materials and Methods:In the multicenter Study of Osteoporotic Fractures (SOF), we studied the relationship of several different BMD measures to fracture risk of multiple types in 9704 non-black women aged 65 and older. We previously reported on the relationship of peripheral BMD measures to risk of several types of fracture during an average 2.2-year follow-up period. In this expanded analysis, we present results of the relationship of both peripheral and central BMD measures and fractures of multiple types during 10.4 and 8.5 years of follow-up, respectively. We also report population attributable risk (PAR) estimates for osteoporosis and risk of several types of fracture. Results: Our results show that almost all types of fractures have an increased incidence in women with low BMD. However, hip BMD is somewhat more strongly related to most of the fracture types studied than spine or peripheral BMD measures. Nonetheless, the proportion of fractures attributable to osteoporosis (based on a standard definition of osteoporosis) is modest, ranging from Ͻ10% to 44% based on the most commonly used definition of osteoporosis (BMD T-score Ͻ Ϫ2.5). Conclusion: Finding effective prevention strategies for fractures in older women will require additional interventions beside preventions for bone loss, such as prevention of falls and other fracture risk factors.

Osteoporosis and fractures in systemic lupus erythematosus

“…Importantly, among the patients with vertebral fractures, 29 -35.8% had normal BMD (24,50). This finding is in line with results from studies in the general population reporting that the proportion of fractures attributable to osteoporosis is only 10 -44% (51).These data point to the limited value of BMD measurement in the assessment of future fracture risk.…”

Tibial or hip BMD predict clinical fracture risk equally well: results from a prospective study in 700 elderly Swiss women

“…The National Osteoporosis Risk Assessment (NORA) study reported similar results for heel, forearm and finger BMD [13]. These findings were confirmed by the 10-year data of the Study of Osteoporotic Fractures (SOF), which reported RR values around 1.4 for six different BMD measurement sites (distal and proximal radius, heel, spine, total hip and femoral neck) [14]. In the present study, the adjusted HR for any clinical fracture attributed to a decrease of 1 SD in BMD was 1.5 for T-DIA and 1.8 for T-EPI.…”

A hybrid FDTD-Rayleigh integral computational method for the simulation of the ultrasound measurement of proximal femur

“…Fracture risk is best predicted by site-matched measurement of areal bone mineral density (aBMD) with dual-energy X-ray absorptiometry [2]. However, aBMD alone is not sufficient to account for bone strength [3,4]. The development of a quantitative ultrasound (QUS) hip scanner [5,6] aims at providing an alternative to aBMD measurements.…”