Improving risk assessment: hip geometry, bone mineral distribution and bone strength in hip fracture cases and controls. The EPOS study. European Prospective Osteoporosis Study

摘要: Hip geometry and bone mineral density (BMD) have previously been shown to relate independently hip fracture risk. Our objective was determine by how much geometric data improved the identification of fracture. Lunar pencil beam scans proximal femur were obtained. Geometric densitometric values from 800 female controls aged 60 years or more (from population samples which participants in European Prospective Osteoporosis Study, EPOS) compared with 68 patients over who scanned within 4 weeks a contralateral We used DPX ‘beta’ versions strength analysis (HSA) axis length (HAL) applied DPX(L) data. Compressive stress (Cstress), calculated HSA software occur as result typical fall on greater trochanter, HAL, body mass index (BMI: weight/(height)2) age considered alongside femoral neck BMD (FN-BMD, g/cm2) potential predictors Logistic regression generate initially FN-BMD. Next age, Cstress (as most discriminating HSA-derived parameter), HAL BMI added model potentially independent predictors. It not necessary include both logistic models, so entire set examined without excluding subjects missing measurements. combined provided significantly better prediction than FN-BMD alone is current practice, judged comparing areas under receiver operating characteristic (ROC) curves (p<0.001, deLong’s test). At specificity 80%, sensitivity 66% 81%. Identifying women at high risk thus likely be substantially enhanced combining simple anthropometry structural hip. might prove valuable enhancement DXA densitometry clinical practice its use could justify pro-active approach identifying community.