International variation in proximal femur bone mineral density

Paggiosi, Margaret; Glueer, Claus-Christian; Roux, Christian; Reid, David M.; Felsenberg, Dieter; Barkmann, Reinhard; Eastell, Richard

doi:10.1007/s00198-010-1336-9

Cited by 19 publications

(7 citation statements)

References 18 publications

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“…On average, our subset was broadly similar to the full population in terms of baseline characteristics, but the women in our subset did have higher total hip BMD (P< 0.001) and higher broadband ultrasound attenuation at the heel (P<0.01) (post hoc analysis). However, site-specific differences in BMD were observed across the whole of the OPUS study [22]. Nevertheless, the incidence of vertebral fracture in our subset may have been lower than might have been observed in the full baseline population; thus, our results may not be directly applicable to the wider population.…”

Section: Discussioncontrasting

confidence: 44%

Association between incident and baseline vertebral fractures in European women: vertebral fracture assessment in the Osteoporosis and Ultrasound Study (OPUS)

et al. 2011

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Section: Discussioncontrasting

confidence: 44%

Association between incident and baseline vertebral fractures in European women: vertebral fracture assessment in the Osteoporosis and Ultrasound Study (OPUS)

et al. 2011

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“…This is different from studies in other countries. In previous studies, European between-center differences in BMD were observed in the European Vertebral Osteoporosis (EVO) 9 , the Network in Europe on Male Osteoporosis (NEMO) 10 and the Osteoporosis and Ultrasound study (OPUS) 12 . In a study published in 1997 9 of 16 European populations, both males and females aged between 50 and 80 were recruited randomly from local population registers.…”

Section: Discussionmentioning

confidence: 99%

“…For men, age-adjusted total hip BMD was lower in Bergen compared with Tromsø. In 2011 12 , proximal femur BMD of females aged 20–39 (n = 258) and males aged 55–79 (n = 1,426) from three European centers were compared. A clear geographical difference in hip BMD did exist; however, there was less evidence for femoral neck BMD 12 .…”

Section: Discussionmentioning

confidence: 99%

“…Dual x-ray absorptiometry (DXA) is widely used to determine BMD in osteoporosis-related studies 8 . Several studies in Europe 9–12 , Canada 13 and Mexico 14 have consistently found geographic variation in BMD; however, evidence is scarce in the United States. Only one study 15 two decades ago showed that there was a small difference (1–4%) in femur BMD between various United States regions.…”

Section: Introductionmentioning

confidence: 99%

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Geographical differences in osteoporosis, obesity, and sarcopenia related traits in white American cohorts

Zhou

Shen

et al. 2019

Sci Rep

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It has been reported that geographical variation influences bone mineral density (BMD), obesity, and sarcopenia related traits in other countries. However, there is lack of similar studies in the US population. In this study, we compared data from three US study cohorts to evaluate geographical variations of BMD and body composition. BMD, fat mass and lean mass were collected from Dual-energy X-ray absorptiometry machine. ANCOVA and Chi-square tests were used to compare the differences between BMDs, obesity and sarcopenia related traits from different regional sites (Omaha, Kansas City and Baton Rouge/New Orleans). Eta-squared was used to measure the effect sizes of these differences. A total of 11,315 Caucasians from our previous three study cohorts were compared. There was no significant geographical difference in BMD for males or females under the criteria of p-values < 0.05 and effect size η 2 > 0.01. There were significant geographical differences with medium effect size (p-value < 0.001, 0.01 < η 2 < 0.14) for whole body fat mass percentage and index of low muscle mass. For Caucasians in the United States, there is no significant geographical effect found on BMD. The obesity and sarcopenia related traits are significantly different between the three study cohorts.

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“…In the current standard-of-care for predicting fracture risk using FRAX™ (Kanis et al 2009), dual-energy X-ray absorptiometry scan-based areal bone mineral density (DXA-aBMD) measured at the femoral neck is used as a surrogate measure of bone strength. Ageing is another risk factor, as it leads to progressive losses in bone strength (Paggiosi et al 2011) and in neuro-motor control (Larsson and Ramamurthy 2000) which can cause fall frequency to increase. Ensrud (2013) recently described in detail the epidemiology of hip fracture risk with advancing age.…”

Section: Introductionmentioning

confidence: 99%

A multiscale model to predict current absolute risk of femoral fracture in a postmenopausal population

Bhattacharya

Altai

Qasim

et al. 2018

Biomech Model Mechanobiol

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Osteoporotic hip fractures are a major healthcare problem. Fall severity and bone strength are important risk factors of hip fracture. This study aims to obtain a mechanistic explanation for fracture risk in dependence of these risk factors. A novel modelling approach is developed that combines models at different scales to overcome the challenge of a large space–time domain of interest and considers the variability of impact forces between potential falls in a subject. The multiscale model and its component models are verified with respect to numerical approximations made therein, the propagation of measurement uncertainties of model inputs is quantified, and model predictions are validated against experimental and clinical data. The main results are model predicted absolute risk of current fracture (ARF0) that ranged from 1.93 to 81.6% (median 36.1%) for subjects in a retrospective cohort of 98 postmenopausal British women (49 fracture cases and 49 controls); ARF0 was computed up to a precision of 1.92 percentage points (pp) due to numerical approximations made in the model; ARF0 possessed an uncertainty of 4.00 pp due to uncertainties in measuring model inputs; ARF0 classified observed fracture status in the above cohort with AUC = 0.852 (95% CI 0.753–0.918), 77.6% specificity (95% CI 63.4–86.5%) and 81.6% sensitivity (95% CI 68.3–91.1%). These results demonstrate that ARF0 can be computed using the model with sufficient precision to distinguish between subjects and that the novel mechanism of fracture risk determination based on fall dynamics, hip impact and bone strength can be considered validated.

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International variation in proximal femur bone mineral density

Abstract: International variation in hip BMD does exist, with international and between-centre differences being less evident at the femoral neck.

Cited by 19 publications

References 18 publications

Association between incident and baseline vertebral fractures in European women: vertebral fracture assessment in the Osteoporosis and Ultrasound Study (OPUS)

Association between incident and baseline vertebral fractures in European women: vertebral fracture assessment in the Osteoporosis and Ultrasound Study (OPUS)

Geographical differences in osteoporosis, obesity, and sarcopenia related traits in white American cohorts

A multiscale model to predict current absolute risk of femoral fracture in a postmenopausal population

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