Association of moderate/severe vertebral fractures with reduced trabecular volumetric bone density in older women and reduced areal femoral neck bone density in older men from the community: A cross-sectional study (SPAH)

Torres, Geórgea Hermógenes Fernandes; Guzman, Luis Fernando Escobar; Alvarenga, Jackeline Couto; Lopes, Neuza; Pereira, Rosa Maria Rodrigues

doi:10.1016/j.maturitas.2018.11.019

Cited by 7 publications

(11 citation statements)

References 28 publications

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“…In our study, DXA T-score and aBMD were similar to a previous study of Torres et al who reported that the majority of fragility fractures occurred in the subjects with osteopenia rather than osteoporosis as determined by aBMD using DXA [34]. Our study showed that approximately 38.2% of women with osteoporosis and 43.1% of women with osteopenia were identified as asymptomatic VF.…”

Section: Discussionsupporting

confidence: 90%

“…However, most of the previous studies focused on different types of fragility fracture in Caucasian women [ 12 , 29 , 30 ], including wrist [ 31 ], hip [ 32 ], and symptomatic vertebral fractures, but not asymptomatic ones in Chinese population [ 28 , 30 , 33 ]. Deterioration of trabecular and cortical bone microarchitecture at the distal radius and tibia was found in fractured patients when compared with non-fractures controls, after adjustment of aBMD in the hip or spine [ 33 , 34 ], where for example, Vranken and co-workers [ 33 ] studied on Caucasian women aged 50–90 years old with a recent non-vertebral fracture and revealed the association of bone microarchitecture and bone strength with prevalent VF. This indicated that women with at least one prevalent vertebral fracture had significantly deteriorated total and trabecular vBMD at both tibia and radius.…”

Section: Discussionmentioning

confidence: 99%

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Performance of HR-pQCT, DXA, and FRAX in the discrimination of asymptomatic vertebral fracture in postmenopausal Chinese women

Huang

Hung

et al. 2021

Arch Osteoporos

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Summary Volumetric bone density (vBMD) and trabecular microarchitecture measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) can discriminate the patients with high risk of asymptomatic vertebral fracture (VF) in postmenopausal Chinese women. These findings suggested that HR-pQCT could provide additional information on bone quality of the patients with asymptomatic VF. Introduction Although there were several studies using HR-pQCT to investigate asymptomatic VF, it remains uncertain if HR-pQCT parameters can discriminate asymptomatic VF patients, especially in Chinese population. The purpose of this study was to investigate whether bone quality measured by HR-pQCT could discriminate asymptomatic VF independent of hip areal bone mineral density (aBMD) measured by dual-energy x-ray absorptiometry (DXA) and fracture risks evaluated using built-in Fracture Risk Assessment Tool (FRAXBMD). Methods This is a nested case–control study. One hundred seventy-five ambulatory Chinese postmenopausal women aged 60–79 years were retrieved from Normative Reference Standards (NRS) cohort in Hong Kong. DXA was used to identify VF from lateral spine images (VFA) using Genant’s semi-quantitative method. Major osteoporotic fracture risk was calculated using FRAX tool. HR-pQCT was used to assess vBMD, microarchitecture, and estimated strength at both distal radius and tibia. Comparison of HR-pQCT parameters between asymptomatic VF and control was performed using covariance analysis. Logistic regression analysis was performed for calculating the adjusted odds ratio (OR) with 95% confidence intervals (CI) of fracture status as per SD decrease in HR-pQCT parameters. Results Women with asymptomatic VF were older than those of the control in our NRS cohort. Nevertheless, after adjusted for covariance, asymptomatic VF showed significantly lower trabecular vBMD (Tb.vBMD) at radius but higher SMI at tibia as compared with those of the control. Tb.vBMD at radius yielded the highest value of area under the curve (AUC) as compared with total hip aBMD and FRAXBMD. However, no significant difference was found among each other. Conclusion Tb.vBMD at the radius and SMI at the tibia provided by HR-pQCT can discriminate asymptomatic VF independent of hip aBMD and FRAXBMD by DXA in postmenopausal women.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Performance of HR-pQCT, DXA, and FRAX in the discrimination of asymptomatic vertebral fracture in postmenopausal Chinese women

Huang

Hung

et al. 2021

Arch Osteoporos

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“…Sixteen of 25 studies included women only, ( 10,11,18‐21,23,26‐31,34‐36 ) six studies men only, ( 12,13,22,24,32,37 ) and three studies both genders. ( 14,25,33 ) For ethnicity, the 25 studies included participants as follows: seven French, ( 10,13,18‐20,22,35 ) five American, ( 12,21,28,29,32 ) four Swedish, ( 24,27,31,37 ) two Canadian, ( 11,23 ) two British, ( 25,34 ) two multiple, ( 14,30 ) one Swiss, ( 36 ) one Asian, ( 26 ) and one Brazilian. ( 33 ) In summary, seven were from North America, one from South America, 14 from Europe, one from Asia, and two from multiple countries (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The full texts of 151 papers were retrieved for further assessment of eligibility; 126 papers were further excluded, because these studies did not involve fracture discrimination or prediction. Hence, 25 papers were finally included in this systematic review including 18 case–control studies ( 10 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ) and seven cohort studies. ( 11 , 12 , 13 , 14 , 35 , 36 , 37 ) Out of 25 papers, only 16 papers were included for meta‐analysis, in which there were 11 case–control studies ( 10 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ) and five cohort studies.…”

Section: Resultsmentioning

confidence: 99%

Best Performance Parameters of HR-pQCT to Predict Fragility Fracture: Systematic Review and Meta-Analysis

Cheung

Hung

Cheuk

et al. 2020

Journal of Bone and Mineral Research

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Osteoporosis is a systemic skeletal disease characterized by low bone mass and bone structural deterioration that may result in fragility fractures. Use of bone imaging modalities to accurately predict fragility fractures is always an important issue, yet the current gold standard of dual‐energy X‐ray absorptiometry (DXA) for diagnosis of osteoporosis cannot fully satisfy this purpose. The latest high‐resolution peripheral quantitative computed tomography (HR‐pQCT) is a three‐dimensional (3D) imaging device to measure not only volumetric bone density, but also the bone microarchitecture in a noninvasive manner that may provide a better fracture prediction power. This systematic review and meta‐analysis was designed to investigate which HR‐pQCT parameters at the distal radius and/or distal tibia could best predict fragility fractures. A systematic literature search was conducted in Embase, PubMed, and Web of Science with relevant keywords by two independent reviewers. Original clinical studies using HR‐pQCT to predict fragility fractures with available full text in English were included. Information was extracted from the included studies for further review. In total, 25 articles were included for the systematic review, and 16 articles for meta‐analysis. HR‐pQCT was shown to significantly predict incident fractures and/or major osteoporotic fractures (MOFs). Of all the HR‐pQCT parameters, our meta‐analysis revealed that cortical volumetric bone mineral density (Ct.vBMD), trabecular thickness (Tb.Th), and stiffness were better predictors. Meanwhile, HR‐pQCT parameters indicated better performance in predicting MOFs than incident fractures. Between the two standard measurement sites of HR‐pQCT, the non‐weight‐bearing distal radius was a more preferable site than distal tibia for fracture prediction. Furthermore, most of the included studies were white‐based, whereas very few studies were from Asia or South America. These regions should build up their densitometric databases and conduct related prediction studies. It is expected that HR‐pQCT can be used widely for the diagnosis of osteoporosis and prediction of future fragility fractures. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

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“…In addition to standard morphological analysis, automatic segmentation software called “advanced cortical analysis” was used to determine cortical parameters 35 , 36 .…”

Section: Methodsmentioning

confidence: 99%

Coronary calcification and bone microarchitecture by high-resolution peripheral quantitative computed tomography from the São Paulo Ageing and Health (SPAH) Study

Guzman

Lopes

Torres

et al. 2022

Sci Rep

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Epidemiological studies reveal a link between osteoporosis and the risk of ischemic cardiovascular disease. We illustrate an association between coronary calcification and bone microarchitecture in older adults based on the SPAH study. This cross-sectional research comprised 256 individuals subjected to cardiac coronary computed tomography angiography (CCTA) for coronary artery calcification (CAC), high-resolution peripheral quantitative computed tomography (HR-pQCT) at the tibia and radius with standardized z score parameters, and dual-energy X-ray absorptiometry (DXA) to evaluate bone status. We used Student’s t test and the Mann–Whitney and Chi-squared tests for comparison of basal measurements. Association analysis was performed using the Poisson regression model with adjustment for CAC and sex. Multivariate analysis revealed different bone variables for predicting CAC in DXA and HR-pQCT scenarios. Although most of the bone parameters are related to vascular calcification, only cortical porosity (Ct.Po) remained uniform by HR-pQCT. Results for were as follows: the tibia—women (exp β = 1.12 (95% CI 1.10–1.13, p < 0.001) and men (exp β = 1.44, 95% CI 1.42–1.46, p < 0.001); the radius—women (exp β = 1.07 (95% CI 1.07–1.08, p < 0.001) and men (exp β = 1.33 (95% CI 1.30–1.37, p < 0.001). These findings suggest an inverse relationship between CAC and cortical bone content, as assessed by HR-pQCT, with higher coronary calcification in individuals older than 65 years.

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Association of moderate/severe vertebral fractures with reduced trabecular volumetric bone density in older women and reduced areal femoral neck bone density in older men from the community: A cross-sectional study (SPAH)

Cited by 7 publications

References 28 publications

Performance of HR-pQCT, DXA, and FRAX in the discrimination of asymptomatic vertebral fracture in postmenopausal Chinese women

Performance of HR-pQCT, DXA, and FRAX in the discrimination of asymptomatic vertebral fracture in postmenopausal Chinese women

Best Performance Parameters of HR-pQCT to Predict Fragility Fracture: Systematic Review and Meta-Analysis

Coronary calcification and bone microarchitecture by high-resolution peripheral quantitative computed tomography from the São Paulo Ageing and Health (SPAH) Study

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