title: Femoral bone mineral density, neck-shaft angle and mean femoral neck width as predictors of hip fracture in men and women. Multicenter Project for Research in Osteoporosis.
abstract: The effect of femoral bone mineral density (BMD) and several parameters of femoral neck geometry (hip axis length, neck-shaft angle and mean femoral neck width) on hip fracture risk in a Spanish population was assessed in a cross-sectional study. All parameters were determined by dual-energy X-ray absorptiometry. There were 411 patients (116 men, 295 women; aged 60-90 years) with hip fractures in whom measurements were taken in the contralateral hip. Controls were 545 persons (235 men, 310 women; aged 60-90 years) who participated in a previous study on BMD in a healthy Spanish population. Femoral neck BMD was significantly lower, and neck-shaft angle and mean femoral neck width significantly higher, in fracture cases than in controls. The logistic regression analysis adjusted by age, height and weight showed that a decrease of 1 standard deviation (SD) in femoral neck BMD was associated with an odds ratio of hip fracture of 4.52 [95% confidence interval (CI) 2.93 to 6.96] in men and 4.45 (95% CI 3.11 to 6.36) in women; an increase of 1 SD in neck-shaft angle of 2.45 (95% CI 1.73 to 3.45) in men and 3.48 (95% CI 2.61 to 4.65) in women; and an increase of 1 SD in mean femoral neck width of 2.15 (95% CI 1.55 to 2.98) in men and 2.40 (95% CI 1.79 to 3.22) in women. The use of a combination of femoral BMD and geometric parameters of the femoral neck except for hip axis length may improve hip fracture risk prediction allowing a better therapeutic strategy for hip fracture prevention.
authors.affiliation: Servicio de Metabolismo Oseo y Mineral, Instituto Reivia Sofía de Investigacion, Hospital Central de Asturias, Oviedo, Spain. cgomez@hca.es
authors.forename: C G
authors.initials: CG
authors.lastname: Alonso
authors.forename: M D
authors.initials: MD
authors.lastname: Curiel
authors.forename: F H
authors.initials: FH
authors.lastname: Carranza
authors.forename: R P
authors.initials: RP
authors.lastname: Cano
authors.forename: A D
authors.initials: AD
authors.lastname: Peréz
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006620:Hip Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000503:physiopathology; D010387:Pelvimetry; D012307:Risk Factors