Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA; Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA; Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA; Department of Mechanical Engineering and Materials Science, Pratt School of Engineering, Duke University, Durham, NC, USA.
J Biomech. 2021 Nov 9;128:110707. doi: 10.1016/j.jbiomech.2021.110707. Epub 2021 Aug 26.
Hip fractures are a significant burden on the aging population, often resulting in reduced mobility, loss of independence, and elevated risk of mortality. While fracture risk is generally inversely related to bone mineral density (BMD), people with diabetes suffer a higher fracture rate despite having a higher BMD. To better understand the connection between diabetes and fracture risk, we developed a method to measure the minimum moment of inertia (mMOI; a geometric factor associated with fracture risk) from clinical CT scans of the pelvis. Since hip fractures are more prevalent in women, we focused on females in this study. We hypothesized that females with diabetes would have a lower mMOI along the femoral neck than those without diabetes, indicative of a higher fracture risk. Three-dimensional models of each hip were created from clinical CT scans of 40 older women (27 with diabetes: 10 fracture/17 non-fractured; 13 without diabetes: non-fractured controls). The mMOI of each hip (n = 80) was reported as the average from three trials. People with diabetes had an 18% lower mMOI as compared to those without diabetes after adjusting for age and BMI (p = 0.02). No differences in the mMOIs between the fractured and contralateral hips in the diabetic group were observed (p = 0.78). Similarly, no differences were observed between the fractured and non-fractured hips of people with diabetes (p = 0.29) when accounting for age and BMI. This suggests structural differences in the hips of individuals with diabetes (measured by the mMOI) may be associated with their elevated fracture risk.
髋部骨折是老龄化人口的一个重大负担，常导致活动能力下降、丧失独立性和死亡率升高。虽然骨折风险通常与骨密度（BMD）呈负相关，但患有糖尿病的人骨折率更高，尽管他们的 BMD 更高。为了更好地了解糖尿病与骨折风险之间的关系，我们开发了一种从骨盆临床 CT 扫描中测量最小惯性矩（mMOI；与骨折风险相关的几何因素）的方法。由于髋部骨折在女性中更为常见，因此我们在这项研究中主要关注女性。我们假设患有糖尿病的女性股骨颈处的 mMOI 低于没有糖尿病的女性，表明骨折风险更高。从 40 名老年女性（27 名患有糖尿病：10 名骨折/17 名未骨折；13 名未患有糖尿病：未骨折对照）的临床 CT 扫描中创建了每个髋部的三维模型。报告了每个髋部（n=80）的 mMOI 作为三次试验的平均值。调整年龄和 BMI 后，患有糖尿病的人的 mMOI 比没有糖尿病的人低 18%（p=0.02）。在糖尿病组中，未发现骨折侧与对侧髋部的 mMOI 之间存在差异（p=0.78）。同样，当考虑年龄和 BMI 时，也未观察到患有糖尿病的人骨折侧与未骨折侧髋部的 mMOI 之间存在差异（p=0.29）。这表明患有糖尿病的个体髋部的结构差异（通过 mMOI 测量）可能与其升高的骨折风险有关。
