Prediction of hip osteoporotic fractures from composite indices of femoral neck strength

Li, Guanwu; Chang, Shixin; Zheng, Xu; Chen, Yao; Bao, Hong; Xiao, Shi

doi:10.1007/s00256-012-1473-7

Cited by 30 publications

(16 citation statements)

References 20 publications

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“…The final study by Dretakis et al found a shorter HAL in patients with a hip fracture: 9.4 cm nonadjusted and 9.6 cm age-adjusted vs 10.0 cm in controls (17). Finally, 6 of the 7 cross-sectional studies that adjusted for BMD (25,28,35,37,39,44,49) found a significant association between a longer HAL and hip fracture in postmenopausal women.…”

Section: Hip Axis Lengthmentioning

confidence: 89%

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Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 1: Hip Geometry

Broy¹,

Cauley²,

Lewiecki³

et al. 2015

Journal of Clinical Densitometry

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Section: Hip Axis Lengthmentioning

confidence: 89%

“…There were no African Americans and only 3 studies evaluated an Asian population (all Chinese) (28,30,35). Of these, only the small study by Li with 43 hip fractures suggested an association between HAL and hip fracture (35).…”

Section: Hip Axis Lengthmentioning

confidence: 97%

Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 1: Hip Geometry

Broy¹,

Cauley²,

Lewiecki³

et al. 2015

Journal of Clinical Densitometry

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“…We also made the simplifying assumption that mineral mass in the femoral neck is largely in the cortex since details of bone composition are not readily available from DXA scans; however, cross-validation with 3D quantitative computed tomography (QCT)-based strength measures confirm the validity of these DXA-based measures [35], which are also more readily obtainable with substantially less radiation exposure and lower costs than QCT. Although the composite strength indices have not been validated against laboratory measures of mechanical strength, they have been shown to be inversely associated with fracture risk in multiple studies [11, 12, 36, 37]. Lastly, more than half of the participants in the Hip Strength Sub-Study cohort were not included in the longitudinal analysis because they did not have definable FMP dates.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of femoral neck strength in relation to the final menstrual period in a multi-ethnic cohort

et al. 2013

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Summary The purpose of this study was to describe the evolution of femoral neck strength relative to load across the menopause transition. It declined significantly over the 10 years bracketing the final menstrual period, and the rate of decline was modified by body mass index, race/ethnicity, and smoking status. Introduction Composite indices of femoral neck strength, which integrate dual energy X-ray absorptiometry (DXA)-derived bone mineral density and bone size with body size, are inversely associated with hip fracture risk. Our objective was to describe longitudinal trajectories of the strength indices across the menopausal transition. Methods Data came from the Study of Women’s Health Across the Nation; participants were pre- or early peri-menopausal, ages 42–53 at baseline, and were followed up for 9.1±1.8 years. Composite indices of femoral neck strength in different failure modes (compression, bending, and impact) were created in 921 women who had three or more hip DXA scans and had definable final menstrual period (FMP) dates. We used mixed effects models to fit piecewise linear growth curves to the baseline-normalized strength indices as a function of time to/after the FMP. Results Compression and impact strength indices did not decline until 1 year prior to the FMP, and declined rapidly thereafter, with some slowing of decline 1 year after the FMP. Bending strength index increased slightly until 2 years prior to the FMP, then plateaued, and began to decline at the FMP. Mean decline in strength indices over 10 years was 6.9 % (compression), 2.5 % (bending), and 6.8 % (impact). Women with higher body mass index had larger declines in two of the three indices. Other major modifiers of rates of decline were race/ethnicity and smoking status. Conclusions Femoral neck strength relative to load declines significantly during the menopausal transition, with declines commencing 1 to 2 years prior to the FMP.

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“…Factors contributing to skeletal strength and resistance to fracture including bone turnover, bone mineralization, cortical macrogeometry, and trabecular microarchitecture are not fully captured by BMD (15). There is growing interest in the association between skeletal integrity and marrow fat depots.…”

Section: Discussionmentioning

confidence: 98%

MR spectroscopy for assessing the effects of oxytocin on marrow adipogenesis induced by glucocorticoid in rabbits

Jiang

Sun

et al. 2015

Acta Radiol

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Prediction of hip osteoporotic fractures from composite indices of femoral neck strength

Abstract: Composite indices of femoral neck strength may be valuable in the assessment of the biomechanics of bone fragility; however, they do not appear to add diagnostic value to the simple measurement of BMD.

Cited by 30 publications

References 20 publications

Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 1: Hip Geometry

Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 1: Hip Geometry

Trajectories of femoral neck strength in relation to the final menstrual period in a multi-ethnic cohort

MR spectroscopy for assessing the effects of oxytocin on marrow adipogenesis induced by glucocorticoid in rabbits

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