Universität zu Köln

Borggrefe, Jan ORCID: 0000-0003-2908-7560, de Buhr, Timm, Shrestha, Smriti, Marshall, Lynn M., Orwoll, Eric, Peters, Kathy, Black, Dennis M. and Gluer, Claus C. (2016). Association of 3D Geometric Measures Derived From Quantitative Computed Tomography With Hip Fracture Risk in Older Men. J. Bone Miner. Res., 31 (8). S. 1550 - 1559. HOBOKEN: WILEY-BLACKWELL. ISSN 1523-4681

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Abstract

We investigated the associations of 3D geometric measures and volumetric bone mineral density (vBMD) of the proximal femur assessed by quantitative computed tomography (QCT) with hip fracture risk among elderly men. This study was a prospective case-cohort design nested within the Osteoporotic Fractures in Men Study (MrOS) cohort. QCT scans of 230 men (65 with confirmed hip fractures) were evaluated with Mindways' QCTPRO-BIT software. Measures that are indicative of bone strength for the femoral neck (FN) and for the trochanteric region (TR) were defined. Bending strength measures were estimated by minimum section modulus, buckling strength by buckling ratio, and a local thinning index (LTI). Integral and trabecular vBMD measures were also derived. Areal BMD (aBMD) of the total proximal femur from dual-energy X-ray absorptiometry (DXA) is presented for comparison. Associations of skeletal measures with incident hip fracture were estimated with hazard ratios (HR) per standard deviation and their 95% confidence intervals (CI) from Cox proportional hazard regression models with adjustment for age, body mass index (BMI), site, and aBMD. Men with hip fractures were older than men without fracture (77.1 +/- 6.0 years versus 73.3 +/- 5.7 years, p < 0.01). Age, BMI, and site-adjusted HRs were significant for all measures except TR_LTI. Total femural BMD by DXA (HR = 4.9, 95% CI 2.5-9.9) and QCT (HR +/- 5.5, 95% CI 2.5-11.7) showed the strongest association followed by QCT FN integral vBMD (HR = 3.6, 95% CI 1.8-6.9). In models that additionally included aBMD, FN buckling ratio (HR = 1.9, 95% CI 1.1-3.2) and trabecular vBMD of the TR (HR = 2.0, 95% CI 1.2-3.4) remained associated with hip fracture risk, independent of aBMD. QCT-derived 3D geometric indices of instability of the proximal femur were significantly associated with incident hip fractures, independent of DXA aBMD. Buckling of the FN is a relevant failure mode not entirely captured by DXA. Further research to study these relationships in women is warranted. (C) 2016 American Society for Bone and Mineral Research.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED de Buhr, Timm UNSPECIFIED UNSPECIFIED UNSPECIFIED Shrestha, Smriti UNSPECIFIED UNSPECIFIED UNSPECIFIED Marshall, Lynn M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Orwoll, Eric UNSPECIFIED UNSPECIFIED UNSPECIFIED Peters, Kathy UNSPECIFIED UNSPECIFIED UNSPECIFIED Black, Dennis M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gluer, Claus C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-267152
DOI:	10.1002/jbmr.2821
Journal or Publication Title:	J. Bone Miner. Res.
Volume:	31
Number:	8
Page Range:	S. 1550 - 1559
Date:	2016
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1523-4681
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BONE-MINERAL DENSITY; FEMORAL-NECK STRENGTH; PROXIMAL FEMUR; OSTEOPOROTIC FRACTURES; ELDERLY-MEN; CORTICAL BONE; WOMEN; PREDICTION; BMD; QCT Multiple languages Endocrinology & Metabolism Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26715