IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, Australia.
Faculty of Health, Deakin University, Biostatistics Unit, Geelong, Australia.
Arch Osteoporos. 2024 Nov 7;19(1):110. doi: 10.1007/s11657-024-01471-7.
Hip structural analysis parameters are associated with risk of fracture in women across a long follow-up period, with buckling ratio persisting independent of total hip BMD.
Hip structural analysis (HSA) uses dual X-ray absorptiometry (DXA) hip scans to calculate geometries of narrow neck (NN), intertrochanter (IT), and shaft (S), which may complement bone mineral density (BMD) for assessing fracture risk. We aimed to determine whether HSA parameters were associated with fracture.
Participants were women (n = 986, ages 40-94 year) from the Geelong Osteoporosis Study. HSA was calculated from Lunar DPX-L scans. Low-trauma incident fractures were identified radiologically. Participants were followed from baseline to first fracture, death, or end of follow-up period (31/12/16) (13,487 person-years follow-up). Time-updating Cox-proportional hazards modelling investigated associations between HSA parameters and fracture.
Three hundred thirty-five participants reported fractures (rate: 24.99/1000 person-years [95% CI 22.46-27.80]). Higher NN BMD (HR:0.12, 95% CI:0.05-0.29), cross-sectional area (CSA) (0.37, 0.26-0.52), cross-sectional moment of inertia (CSMI) (0.66, 0.50-0.89), section modulus (SM) (0.40, 0.24-0.68) and cortical thickness (CT) (0.00, 0.00-0.01 due to rounding) were associated with decreased risk. IT BMD (0.08, 0.04-0.20), CSA (0.58, 0.49-0.69), CSMI (0.90, 0.85-0.94), and SM (0.69, 0.59-0.81) were similarly associated. Decreased risk was observed at increased values of S BMD (0.20, 0.10-0.38), CSA (0.60, 0.47-0.76), SM (0.60, 0.43-0.83), and CT (0.03, 0.01-0.14). Higher S endocortical diameter (1.81, 1.29-2.53), and buckling ratio (BR) at all sites (NN: 1.07, 1.04-1.11; IT: 1.08, 1.05-1.11, S: 1.31, 1.19-1.46) were associated with increased risk. After adjustment for total hip BMD, the associations with BR at the shaft (1.14, 1.00-1.30) were sustained. Other associations were attenuated.
A greater shaft buckling ratio was associated with an increased risk for fracture, independent of total hip BMD.
髋关节结构分析（HSA）使用双能 X 射线吸收法（DXA）髋关节扫描来计算窄颈（NN）、转子间（IT）和骨干（S）的几何形状，这可能会补充骨矿物质密度（BMD）来评估骨折风险。我们旨在确定 HSA 参数是否与骨折有关。
参与者为来自 Geelong 骨质疏松症研究的 986 名女性（年龄 40-94 岁）。HSA 是从 Lunar DPX-L 扫描中计算出来的。通过放射学确定低创伤性的骨折。从基线到首次骨折、死亡或随访期结束（31/12/16）（13487 人年随访）对参与者进行随访。时间更新的 Cox 比例风险模型研究了 HSA 参数与骨折之间的关联。
更大的骨干弯曲比与骨折风险增加相关，独立于全髋关节 BMD。
