Cortical and trabecular bone microarchitecture as an independent predictor of incident fracture risk in older women and men in the Bone Microarchitecture International Consortium (BoMIC): a prospective study

Publication date: Available online 28 November 2018Source: The Lancet Diabetes & EndocrinologyAuthor(s): Elizabeth J Samelson, Kerry E Broe, Hanfei Xu, Laiji Yang, Steven Boyd, Emmanuel Biver, Pawel Szulc, Jonathan Adachi, Shreyasee Amin, Elizabeth Atkinson, Claudie Berger, Lauren Burt, Roland Chapurlat, Thierry Chevalley, Serge Ferrari, David Goltzman, David A Hanley, Marian T Hannan, Sundeep Khosla, Ching-Ti LiuSummaryBackgroundAlthough areal bone mineral density (aBMD) assessed by dual-energy x-ray absorptiometry (DXA) is the clinical standard for determining fracture risk, most older adults who sustain a fracture have T scores greater than −2·5 and thus do not meet the clinical criteria for osteoporosis. Importantly, bone fragility is due to low BMD and deterioration in bone structure. We assessed whether indices of high-resolution peripheral quantitative CT (HR-pQCT) were associated with fracture risk independently of femoral neck aBMD and the Fracture Risk Assessment Tool (FRAX) score.MethodsWe assessed participants in eight cohorts from the USA (Framingham, Mayo Clinic), France (QUALYOR, STRAMBO, OFELY), Switzerland (GERICO), Canada (CaMos), and Sweden (MrOS). We used Cox proportional hazard ratios (HRs) to estimate the association between HR-pQCT bone indices (per 1 SD of deficit) and incident fracture, adjusting for age, sex, height, weight, and cohort, and then additionally for femoral neck DXA aBMD or FRAX.Findings7254 individuals (66% women and 34% men) were as...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research