title: Distribution of cortical bone in the femoral neck and hip fracture: a prospective case-control analysis of 143 incident hip fractures; the AGES-REYKJAVIK Study.
abstract: In this prospective nested case-control study we analyzed the circumferential differences in estimated cortical thickness (Est CTh) of the mid femoral neck as a risk factor for osteoporotic hip fractures in elderly women and men. Segmental QCT analysis of the mid femoral neck was applied to assess cortical thickness in anatomical quadrants. The superior region of the femoral neck was a stronger predictor for hip fracture than the inferior region, particularly in men. There were significant gender differences in Est CTh measurements in the control group but not in the case group. In multivariable analysis for risk of femoral neck (FN) fracture, Est CTh in the supero-anterior (SA) quadrant was significant in both women and men, and remained a significant predictor after adjustment for FN areal BMD (aBMD, dimensions g/cm², DXA-like), (p=0.05 and p<0.0001, respectively). In conclusion, Est CTh in the SA quadrant best discriminated cases (n=143) from controls (n=298), especially in men. Cortical thinning superiorly in the hip might be of importance in determining resistance to fracture.
authors.affiliation: University of Iceland, Reykjavik, Iceland. fjolajo@hi.is
authors.forename: Fjola
authors.initials: F
authors.lastname: Johannesdottir
authors.forename: Kenneth E S
authors.initials: KE
authors.lastname: Poole
authors.forename: Jonathan
authors.initials: J
authors.lastname: Reeve
authors.forename: Kristin
authors.initials: K
authors.lastname: Siggeirsdottir
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.forename: Brynjolfur
authors.initials: B
authors.lastname: Mogensen
authors.forename: Brynjolfur Y
authors.initials: BY
authors.lastname: Jonsson
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Vilmundur G
authors.initials: VG
authors.lastname: Gudnason
authors.forename: Gunnar
authors.initials: G
authors.lastname: Sigurdsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D005272:Femur Neck / Q000473:pathology*; D006620:Hip Fractures / Q000473:pathology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed