Relationship between bone mineral density and fragility fracture risk: a case-control study in Changsha, China

Abstract

Background Fragility fracture is associated with bone mineral density (BMD), and most databases used in related researches are instrument-matched. Little is known about the relationship between BMD and fragility fracture risk of native Chinese, especially using local databases as reference databases. Objective To investigate relationship between BMD and risk of fragility fracture in native China. Methods 3,324 cases, including 2,423 women (67.7 ± 8.9 years) and 901 men (68.4 ± 11.6 years) having radiological fragility fractures and 3,324 age- and gender-matched controls participated in the study. We measured BMD at posteroanterior spine and hip using dual-energy X-ray absorptiometry (DXA), calculated BMD measurement parameters based on our own BMD reference database. Results BMDs and mean T-scores were lower in case group (with clinical fragility) than in control group (without clinical fragility). In patients with fragility fractures, prevalence of lumbar osteoporosis, low bone mass, and normal BMD were 78.9 %, 19.3 %, and 1.8 %, respectively, in women, and 49.5, 44.8 %, and 5.7 %, respectively, in men. In hip, these prevalence rates were 67.2 %, 28.4 %, and 4.4 % in females, and 43.2 %, 45.9 %, and 10.9 % in males, respectively, showing differences between females and males. Multivariate Cox regression analysis showed that after adjusting age, height, weight, and body mass index, fracture hazard ratio (HR) increased by 2.7–2.8 times (95 % CI 2.5–3.1) and 3.6–4.1 times (95 %CI 3.0–5.1) for women and men respectively with decreasing BMD parameters. In both sexes, risk of fragility fracture increased approximately 1.6–1.7 times (95 % CI 1.5–1.8) for every 1 T-score reduction in BMD. Conclusions Risk of clinical fragility fracture increases with decreasing BMD measurement parameters and anthropometric indicators in native China, and fracture HR varies from gender and site.

Around the time of a hip fracture, older East Asian female patients tend to measure lower densitometric femoral neck and total hip T-scores than older Caucasian female patients: a literature analysis

“…For male patients, only a 'possible' trend is noted that East Asian patients measure lower total hip T-scores. Another point noted is that, around the timepoint of a hip fracture, at least for East Asians included in this study, male patients tend to measure higher femoral neck and total hip T-scores than those of female patients (Figure 4) (24,28,29,30,32,33). .…”

“…For the data in the articles included for analysis, the results are shown in Figure 1 for female patients (24)(25)(26)(27)(28)(29)(30)(31)(32)(33), Figure 2 for male and female patients mixed (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45), and Figure 3 for male patients (24,(28)(29)(30)32,33,46,47). For the data in Figure 2, females commonly constituted 2/3 of the cases, reflecting that hip fracture prevalence among older women is about double of that among older men.…”

“…Figure 4In total six studies reported both males' data and females' data(24,(28)(29)(30)32,33), data from all four East Asian cohorts show FN and TH T-scores of proximal femur fracture male patients measure higher than those of female patients. A trend for data of Caucasians can not be ascertained.…”

Comparison of Bone Loss and Associated Risk Factors in Men with Spinal Cord Injury and Community-dwelling Adults

“…The overall femoral neck and total hip T-scores in men with SCI were − 1.3 and − 1.7 lower, respectively, compared with those in community-dwelling adults. Since every 1.0 reduction of the T-score re ects a 1.6-1.7 times increase in fragility fracture risk of the vertebra and both upper and lower limbs 22 , the male SCI population in their rst to third years of injury should be regarded as a high fracture risk group, thus increasing awareness for earlier intervention and management to prevent fragility fracture. Vestergaard et al previously demonstrated that the crude fracture rate of individuals with SCI was 2% per year, which was 2 times higher than that of controls, with an exceedingly higher rate of low-energy fractures 23 .…”

Prevalence of Sarcopenia and Its Association with Quality of Life, Postural Stability, and Past Incidence of Falls in Postmenopausal Women with Osteoporosis: A Cross-Sectional Study

“…Patients with osteoporosis receive standardized medical intervention, and BMD is regularly examined using dual-energy X-ray absorptiometry. BMD reflects the effectiveness of any medical intervention and is a well-known parameter for the risk of fragility fracture in these patients [ 18 ].…”