Trabecular bone mineral density as measured by thoracic vertebrae predicts incident hip and vertebral fractures: the multi-ethnic study of atherosclerosis

Li, Dong; Mao, Song Shou; Budoff, Matthew J.

doi:10.1007/s00198-024-07040-5

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…Li et al ( 55 ) investigated the fracture predictive value of QCT-based trabecular BMD of thoracic vertebrae derived from coronary artery calcium scan for hip fractures in the Multi-Ethnic Study of Atherosclerosis (MESA), a nationwide multi-center cohort included 6814 people from six medical centers across the USA. At baseline participants had a mean age of 62.2±10.2 years, and 52.8% were women, 27.6% of participants (n=1,883) had osteoporosis (T-score ≤−2.5).…”

Section: Results Of a Random Selection Of Other Recent Reportsmentioning

confidence: 99%

For older women, the majority of hip fragility fractures and radiographic vertebral fragility fractures occur among the densitometrically osteoporotic population: a literature analysis

Wáng

2024

Quant Imaging Med Surg

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It has been frequently cited that ‘ the majority of fragility fractures (FF) occur at non-osteoporotic bone mineral density (BMD) ’. For the reports with T-score measured around the time of a hip fracture, we conducted a systematic literature search in December 2022, and resulted in 10 studies with five for Caucasian women and five for East Asian women. Femoral neck (FN) T-score was reported in five Caucasian studies and three East Asian studies, three of five Caucasian studies had a mean T-score ≤−2.5, and one study had the majority of their patients measuring a mean T-score ≤−2.5. All three East Asian studies reported a mean FN T-score ≤−2.7. Total hip T-score was reported in two Caucasian studies and three East Asian studies, the two Caucasian studies both had a mean T-score ≤−2.5, and all three East Asian studies had a mean T-score ≤−2.6. A new literature search conducted in April 2024 results in additional three studies, with results being consistent with the data described above. A trend was noted that ‘younger’ patients suffer from hip fractures at a ‘higher’ T-score. For the highly cited articles where the notion the majority of FF occur at non-osteoporotic BMD was derived from, authors reported prospective epidemiological studies where BMD was not measured at the timepoint of hip fracture, instead, BMD was measured at the study baseline. These epidemiological studies suggest that >50% of hip fractures likely occur in women with an osteoporotic FN or hip T-score. However, a pattern was seen that older men suffer from hip fracture at a notably higher T-score than older women. For the cases of radiographic vertebral FF, despite varying criteria being used to classify these FFs, the majority of female patients had spine densitometric osteoporosis. Literature shows, compared with the cases of hip fracture, distal forearm fracture occurs at a ‘younger’ age and ‘higher’ BMD, suggesting distal forearm fracture is more likely associated with a ‘higher’ trauma energy level.

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Section: Results Of a Random Selection Of Other Recent Reportsmentioning

confidence: 99%

For older women, the majority of hip fragility fractures and radiographic vertebral fragility fractures occur among the densitometrically osteoporotic population: a literature analysis

Wáng

2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

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The association of microvascular disease and endothelial dysfunction with vertebral trabecular bone mineral density

Barzilay,

Buzkova,

Bielinski

et al. 2024

Osteoporos Int

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Assessing Thoracic Vertebral Bone Mineral Density (T8-T10) for Osteoporosis Diagnosis During CT Lung Cancer Screening in Older Adults

Li,

Hu,

Wei

et al. 2024

IJGM

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Osteoporosis diagnosis often utilizes quantitative computed tomography (QCT). This study explored the validity of applying lumbar bone mineral density (LBMD) standards to thoracic vertebrae (T8-T10) for osteoporosis detection during CT lung cancer screenings. This study investigated the utility of thoracic BMD (BMD-T8-T10) for detecting osteoporosis in older persons during CT lung cancer screening. Methods: We studied 701 participants who underwent QCT scans for both LBMD and BMD-T8-T10. Osteoporosis was diagnosed using ACR criteria based on LBMD. We determined BMD-T8-T10 thresholds via a receiver operating characteristic (ROC) curve and translated BMD-T8+T9+T10 to LBMD (TTBMD) using linear regression. Kappa test was used to evaluate the accuracy of BMD-T8-T10 thresholds and TTBMD in diagnosing osteoporosis. Results: Raw BMD-T8-T10 poorly identified osteoporosis (kappa = 0.51). ROC curve analysis identified BMD-T8-T10 thresholds for osteopenia (138 mg/cm3) and osteoporosis (97 mg/cm3) with areas under the curve of 0.97 and 0.99, respectively. We normalized BMD-T8-T10 to TTBMD based on the formula: TTBMD = 0.9 × BMD-T8-T10 -2.56. These thresholds (kappa = 0.74) and TTBMD performed well in detecting osteoporosis/osteopenia (kappa = 0.74). Conclusion: Both calculating BMD-T8-T10 threshold (138.0 mg/cm 3 for osteopenia and 97 mg/cm 3 for osteoporosis) and normalizing BMD-T8-T10 to LBMD demonstrated good performance in identifying osteoporosis in older adults during CT lung cancer screening.

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Trabecular bone mineral density as measured by thoracic vertebrae predicts incident hip and vertebral fractures: the multi-ethnic study of atherosclerosis

Cited by 4 publications

References 31 publications

For older women, the majority of hip fragility fractures and radiographic vertebral fragility fractures occur among the densitometrically osteoporotic population: a literature analysis

For older women, the majority of hip fragility fractures and radiographic vertebral fragility fractures occur among the densitometrically osteoporotic population: a literature analysis

The association of microvascular disease and endothelial dysfunction with vertebral trabecular bone mineral density

Assessing Thoracic Vertebral Bone Mineral Density (T8-T10) for Osteoporosis Diagnosis During CT Lung Cancer Screening in Older Adults

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