Relationship of femoral neck areal bone mineral density to volumetric bone mineral density, bone size, and femoral strength in men and women

Abstract

Purpose aBMD by DXA is widely used to identify patients at risk for osteoporotic fractures. aBMD is influenced by bone size (i.e., matched for vBMD, larger bones have higher aBMD), and increasing evidence indicates that absolute aBMD predicts a similar risk of fracture in men and women. Thus, we sought to define the relationships between FN aBMD (assessed by DXA) and vBMD, bone size, and FE-derived femoral strength obtained from quantitative computed tomography scans in men versus women. Methods We studied men and women aged 40 to 90 years and not on osteoporosis medications. Results In 114 men and 114 women matched for FN aBMD, FN total cross-sectional area was 38% higher (P < 0.0001) and vBMD was 16% lower (P < 0.0001) in the men. FE models constructed in a subset of 28 women and 28 men matched for FN aBMD showed relatively similar values for bone strength and the load-to-strength ratio in the two groups. Conclusions In this cohort of young and old men and women from Rochester, Minnesota who are matched by FN aBMD, because of the offsetting effects of bone size and vBMD, femoral strength and the load-to-strength ratio tended to be relatively similar across the sexes.

Fast and easy preoperative estimation of cancellous bone mineral density in patients with proximal femur fractures

“…It was also shown that areal BMD (aBMD) as investigated by DXA is highly influenced by bone size. Thus, larger bones display higher aBMD values, although vBMD (volumetric BMD as obtained by CT scans) proves to be identical [17,27]. Using vBMD the confounding factor of the femoral head size could be reduced.…”

Whole Body Vibration Treatments in Postmenopausal Women Can Improve Bone Mineral Density: Results of a Stimulus Focussed Meta-Analysis

“…Therefore, BMD values of the selected sites were reported for each study both pre and post WBV treatment, as mean and standard deviation (SD). BMD values were reported in g/cm 2 as quantified by dual energy X-ray absorptiometry [19]. …”

Study of sex differences in the association between hip fracture risk and body parameters by DXA-based biomechanical modeling

“…Therefore, they suggested that hip BMD is an excellent test for predicting fracture risk in men. It is also suggested by Keyak et al [49] that femoral strength, strongly correlated with hip BMD [49,78,79], is a more powerful discriminatory tool for assessing hip fracture risk in men than in women. The difference in the association between hip BMD and hip fracture risk in men and women may justify the suggestion of using a sex-specific T-score, rather than the female-normalized one, for assessing hip fracture risk [48,80].…”