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Bone Geometry Analyses Add to Power of Bone Mineral Density in Predicting Fractures: Presented at ASBMR
By John Otrompke
DENVER -- September 13, 2009 -- While bone mineral density (BMD) measured at the femoral neck has long been known to have predictive power in determining future stroke risk, analysis of bone geometry by means of peripheral quantitatively computed tomography (pQCT) offers physicians as many as 36 additional measures which contribute to the efficiency of pQCT, according to a poster presented here at the 31st Annual Meeting of the American Society for Bone and Mineral Research (ASBMR).
Of the 36 measures, 2 in particular added to the predictive power of BMD analysis, noted Yahtyng Sheu, PhD, University of Pittsburgh, Pittsburgh, Pennsylvania, during a poster presentation on September 12.
In particular, cross-sectional moment of inertia and the stress-strain index contribute to a stronger assessment of fracture risk. "The predictive power of BMD alone is about 73% accurate, while the combination of measures is about 80% accurate," said Dr. Sheu.
However, polar moment of inertia, the ability of bone to resist torsion, had only a borderline significance in predicting future fractures, Dr. Sheu said. Additionally, when a single QCT variable was looked at alone, it didn't predict better than BMD by itself, she explained. Insignificant predictors were whether a patient had diabetes or was a current smoker. Men without incident fractures had significantly greater bone mineral content, area and strength than those with fractures.
The study looked at data from 1,143 Caucasian men aged 65 years or older gathered from the Minneapolis and Pittsburgh Centers of the Osteopathic Fractures in Men study. The men were asked about fractures every 4 months and followed up for a mean of 2.9 years. Thirty-nine fractures were confirmed by radiologist in the study. Femoral neck BMD measured by dual energy x-ray absorptiometry was also included.
"There was not enough data to look at hip fractures alone," Dr. Sheu added. "Hip fractures are the most destructive type of fracture," carrying a high risk of dying just 1 year after a hip fracture, she explained.
[Presentation title: Bone Geometry and the Risk of Non-Vertebral Fractures: The MROS Study. Abstract SA0310]
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