Age trends for hip geometry in Chinese men and women and the association with femoral neck fracture

Zhang, H.; Hu, Yuxi; Zhang, Z. L.

doi:10.1007/s00198-010-1479-8

Cited by 29 publications

(23 citation statements)

References 40 publications

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“…It was found not only that FN-BMD was the best hip fracture predictor in males but also that NSA does not predict hip fracture independent of FN-BMD. This agrees with reports by some authors 16,18 but is in contrast to the findings of Alonso et al 14 and the majority of reports in the literature about NSA hip fracture prediction in females. 10,11,14,22,26 Concerning the independence of the ability of NSA to predict hip fracture, the contrasting results between previous studies in females 10,29 and the present one in males might be a result of a statistical weakness of the present study because of the low number of fractures in males.…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, it may be that the negative correlation of FN-BMD with NSA leads BMD to capture some of the effects of NSA on hip fracture; thus explaining, at least partially, the disagreement between males and females regarding the independence of the ability of NSA to predict hip fracture. Zhang et al, 18 who found that NSA does not independently predict hip fracture in females thus showing a significant relationship between NSA and BMD, also seem to support this hypothesis.…”

Section: Discussionmentioning

confidence: 80%

“…7,8 This evidence, however, mainly derives from studies carried out in females, 9-13 whereas contradictory results characterize studies carried out in males. [14][15][16][17][18][19][20] Authors' opinions seem to vary widely about the ability of the neck shaft angle (NSA), one of the PFG factors, to predict osteoporotic hip fractures in males, [14][15][16]21 whereas its association with the risk of hip fracture in females 10,11,14,22 is generally accepted. Gender differences in the hip anatomy 23 have been put forward as a possible explanation for the different relationship of NSA with the hip-fracture risk between genders, whereas geographic and racial differences 24 among the examined male populations have been advocated as a possible cause of authors' discrepancies on the relationship between NSA and the hip-fracture risk in males.…”

Section: Advances In Knowledgementioning

confidence: 99%

See 2 more Smart Citations

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

Ripamonti¹,

Lisi²,

Avella³

2014

The British Journal of Radiology

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Objective: To investigate the specificity of the neck shaft angle (NSA) to predict hip fracture in males. Methods: We consecutively studied 228 males without fracture and 38 with hip fracture. A further 49 males with spine fracture were studied to evaluate the specificity of NSA for hip-fracture prediction. Femoral neck (FN) bone mineral density (FN-BMD), NSA, hip axis length and FN diameter (FND) were measured in each subject by dual X-ray absorptiometry. Between-mean differences in the studied variables were tested by the unpaired t-test. The ability of NSA to predict hip fracture was tested by logistic regression. Results: Compared with controls, FN-BMD (p < 0.01) was significantly lower in both groups of males with fractures, whereas FND (p < 0.01) and NSA (p = 0.05) were higher only in the hip-fracture group. A significant inverse correlation (p < 0.01) was found between NSA and FN-BMD. By age-, height- and weight-corrected logistic regression, none of the tested geometric parameters, separately considered from FN-BMD, entered the best model to predict spine fracture, whereas NSA (p < 0.03) predicted hip fracture together with age (p < 0.001). When forced into the regression, FN-BMD (p < 0.001) became the only fracture predictor to enter the best model to predict both fracture types. Conclusion: NSA is associated with hip-fracture risk in males but is not independent of FN-BMD. Advances in knowledge: The lack of ability of NSA to predict hip fracture in males independent of FN-BMD should depend on its inverse correlation with FN-BMD by capturing, as the strongest fracture predictor, some of the effects of NSA on the hip fracture. Conversely, NSA in females does not correlate with FN-BMD but independently predicts hip fractures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 80%

Section: Advances In Knowledgementioning

confidence: 99%

See 1 more Smart Citation

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

Ripamonti¹,

Lisi²,

Avella³

2014

The British Journal of Radiology

View full text Add to dashboard Cite

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“…FSI and HAL are also reported to change as a result of age. Zhang et al performed the first study investigating the aging trends of hip geometry [23]. After adjustment for height and weight, HAL was shown in this cross-sectional study to increase with age while FSI tended to decrease (Figures 8 and 9) [23].…”

Section: Fsi and Hal: Geometric Measurements To Predict Hip Fracturementioning

confidence: 61%

“…Thus, it is not surprising that lower FSI values appear well correlated to increased fracture incidences. Even after adjustment for BMD and HAL, FSI remains a significant predictor of hip fracture [7,23]. Similarly, HAL has been shown to be a predictor of hip fracture independent of BMD, age, height, and weight.…”

Section: Fsi and Hal: Geometric Measurements To Predict Hip Fracturementioning

confidence: 96%

Advanced Hip Analysis: Simple Geometric Measurements Predict Hip Fracture Beyond Bone Mineral Density

Boudreaux¹,

Sibonga²

2015

TOJ

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Osteoporosis is a condition that affects both the mineral density and geometry of bone, resulting in an increased susceptibility to fracture. Current dual-energy x-ray absorptiometry (DXA) densitometric measurements of bone mineral density (BMD) are unquestionably linked to osteoporosis and serve as a convenient and cost-effective means to monitor bone loss, diagnose osteoporosis, and assess fracture risk in a recognized population at risk for fragility or osteoporotic fractures. Measures of BMD do not, however, unequivocally measure any known mechanical strength properties. Since the fundamental issues inherent to osteoporosis are reduced bone strength and increased fracture risk, it is critical to establish a means of evaluating bone strength at skeletal sites, with clinical and performance relevance, to predict the likelihood of fracture. Thus, the purpose of this paper is to review the literature on methodologies for quantifying geometric parameters of hip bone developed for the widely applied DXA. Most notably, the calculated femur strength index (FSI) and the measured hip axis length (HAL) were evaluated for the ability to predict hip fracture independently of BMD along with the limitations.

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The effects of body mass index and age on cross‐sectional properties of the femoral neck

2015

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Research on the relationship between body mass index (BMI) and cross-sectional geometry of long bone diaphyses demonstrates that strength properties are significantly greater in obese versus normal BMI individuals. However, articular dimensions do not differ appreciably. If femoral head size remains constant, we hypothesize that the femoral neck remodels to accommodate greater loads associated with increased BMI. High-resolution CT scans (n = 170 males) were divided into three BMI groups (normal, overweight, and obese) and two age groups (21-50 and >50). OsiriX software was used to obtain a cross-sectional slice at the waist of the femoral neck. Cortical area (CA), total cross-sectional area (TA), percent cortical area (%CA), circularity index (Imax /Imin ), section modulus (Zpol ), and second moment of area (J) were measured with ImageJ software. The effects of age and BMI were evaluated statistically. Pairwise comparisons in the younger group only detected significant differences between normal and obese males in the circularity index (P = 0.022). The older cohort showed significant differences in CA (P < 0.001), %CA (P = 0.004), Zpol (P = 0.007), and J (P < 0.001) between normal and obese groups. This study shows that the effects of obesity on the cross-sectional geometry of the femoral neck are more pronounced in older males relative to younger males. Older males with increased BMI have greater cortical area and bone strength in the femoral neck relative to younger males, thus making the femoral neck less susceptible to fractures in obese individuals.

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Age trends for hip geometry in Chinese men and women and the association with femoral neck fracture

Abstract: This study demonstrated thinning of the cortical shell and deterioration of the resistance to bending and SI with aging in femoral neck in Chinese men and women. SI may be a risk factor for hip fracture that is independent of BMD measurement in Chinese women.

Cited by 29 publications

References 40 publications

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

Advanced Hip Analysis: Simple Geometric Measurements Predict Hip Fracture Beyond Bone Mineral Density

The effects of body mass index and age on cross‐sectional properties of the femoral neck

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