Associations between ultra-distal forearm bone mineral density and incident fracture in women.
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Abstract summary
Bone mineral density measured at the ultra-distal forearm site was associated with any fracture, as well as distal radius fracture in women from a longitudinal cohort study.Femoral neck (BMD) and lumbar spine (BMD) bone mineral density (BMD) are routinely used to assess fracture risk. More data are needed to understand how ultra-distal forearm BMD (BMD) may assist fracture prediction.Using a Lunar DPX-L, Geelong Osteoporosis Study women (n = 1026), aged 40-90 years, had BMD measured. Incident low-trauma fractures were radiologically verified. Using Cox proportional hazard models, hazard ratios (HR) were calculated for BMD as a continuous variable (expressed as a one-unit decrease in T-score) and a categorical variable (normal/osteopenia/osteoporosis). Areas under receiver operating characteristics (AUROC) curves were calculated. Analyses were conducted for any fracture and distal radius fractures.During 14,270 person-years of follow-up, there were 318 fractures (85 distal radius). In adjusted models, continuous BMD was associated with any (HR 1.26;95%CI 1.15-1.39) and distal radius fractures (HR 1.59;95%CI 1.38-1.83). AUROCs for continuous BMD, 33% forearm(BMD), BMD, BMD, and FRAX without BMD were similar for any fracture (p > 0.05). For distal radius fracture, the AUROC for BMD was higher than other sites and FRAX (p < 0.05). In adjusted models, those with osteoporosis had a higher likelihood of any fracture (HR 2.12; 95%CI 1.50-2.98). For distal radius fractures, both osteopenia and osteoporosis had a higher risk (HR 4.31; 95%CI 2.59-7.15 and 4.81; 95%CI 2.70-8.58). AUROCs for any fracture were similar for categorical BMD at all sites but lower for FRAX (p < 0.05). For distal radius fractures, the AUROC for BMD, was higher than other sites and FRAX (p < 0.05).Ultra-distal forearm BMD may aid risk assessments for any distal radius fractures.Study Outcome
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Citations : LeBoff MS, Greenspan SL, Insogna KL et al (2022) The clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 33:2049–2102. https://doi.org/10.1007/s00198-021-05900-yAuthors : 5
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Doi : 10.1007/s00198-024-07041-4SSN : 1433-2965