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Bone strength measured by peripheral quantitative computed tomography and the risk of nonvertebral fractures: The osteoporotic fractures in men (MrOS) study

Sheu, Y and Zmuda, JM and Boudreau, RM and Petit, MA and Ensrud, KE and Bauer, DC and Gordon, CL and Orwoll, ES and Cauley, JA (2011) Bone strength measured by peripheral quantitative computed tomography and the risk of nonvertebral fractures: The osteoporotic fractures in men (MrOS) study. Journal of Bone and Mineral Research, 26 (1). 63 - 71. ISSN 0884-0431

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Many fractures occur in individuals without osteoporosis defined by areal bone mineral density (aBMD). Inclusion of other aspects of skeletal strength may be useful in identifying at-risk subjects. We used surrogate measures of bone strength at the radius and tibia measured by peripheral quantitative computed tomography (pQCT) to evaluate their relationships with nonvertebral fracture risk. Femoral neck (FN) aBMD, measured by dual-energy X-ray absorptiometry (DXA), also was included. The study population consisted of 1143 white men aged 69+ years with pQCT measures at the radius and tibia from the Minneapolis and Pittsburgh centers of the Osteoporotic Fractures in Men (MrOS) study. Principal-components analysis and Cox proportional-hazards modeling were used to identify 21 of 58 pQCT variables with a major contribution to nonvertebral incident fractures. After a mean 2.9 years of follow-up, 39 fractures occurred. Men without incident fractures had significantly greater bone mineral content, cross-sectional area, and indices of bone strength than those with fractures by pQCT. Every SD decrease in the 18 of 21 pQCT parameters was significantly associated with increased fracture risk (hazard ration ranged from 1.4 to 2.2) independent of age, study site, body mass index (BMI), and FN aBMD. Using area under the receiver operation characteristics curve (AUC), the combination of FN aBMD and three radius strength parameters individually increased fracture prediction over FN aBMD alone (AUC increased from 0.73 to 0.80). Peripheral bone strength measures are associated with fracture risk and may improve our ability to identify older men at high risk of fracture. © 2011 American Society for Bone and Mineral Research.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Sheu, Yyas12@pitt.eduYAS12
Zmuda, JMZmudaJ@edc.pitt.eduEPIDJMZ
Boudreau, RMrob21@pitt.eduROB21
Petit, MA
Ensrud, KE
Bauer, DC
Gordon, CL
Orwoll, ES
Cauley, JAJCauley@edc.pitt.eduJCAULEY
Date: 1 January 2011
Date Type: Publication
Journal or Publication Title: Journal of Bone and Mineral Research
Volume: 26
Number: 1
Page Range: 63 - 71
DOI or Unique Handle: 10.1002/jbmr.172
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 0884-0431
Date Deposited: 03 Apr 2015 17:45
Last Modified: 02 Jul 2022 10:56


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