title: Fracture risk assessment in older adults using a combination of selected quantitative computed tomography bone measures: a subanalysis of the Age, Gene/Environment Susceptibility-Reykjavik Study.
abstract: Bone mineral density (BMD) and geometric bone measures are individually associated with prevalent osteoporotic fractures. Whether an aggregate of these measures would better associate with fractures has not been examined. We examined relationships between self-reported fractures and selected bone measures acquired by quantitative computerized tomography (QCT), a composite bone score, and QCT-acquired dual-energy X-ray absorptiometry-like total femur BMD in 2110 men and 2682 women in the Age, Gene/Environment Susceptibility-Reykjavik Study. The combined bone score was generated by summing gender-specific Z-scores for 4 QCT measures: vertebral trabecular BMD, femur neck cortical thickness, femur neck trabecular BMD, and femur neck minimal cross-sectional area. Except for the latter measure, lower scores for QCT measures, singly and combined, showed positive (p < 0.05) associations with fractures. Results remained the same in stratified models for participants not taking bone-promoting medication. In women on bone-promoting medication, greater femur neck cortical thickness and trabecular BMD were significantly associated with fracture status. However, the association between fracture and combined bone score was not stronger than the associations between fracture and individual measures or total femur BMD. Thus, the selected measures did not all similarly associate with fracture status and did not appear to have an additive effect on fracture status.
authors.affiliation: Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, UT Medical School at Houston, TX, USA. Electronic address: Nahid.J.Rianon@uth.tmc.edu.
authors.forename: Nahid J
authors.initials: NJ
authors.lastname: Rianon
authors.affiliation: Radiology and Biomedical Imaging, UCSF School of Medicine, San Francisco, CA, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lang
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland.
authors.forename: Kristin
authors.initials: K
authors.lastname: Siggeirsdottir
authors.affiliation: Division of Endocrinology & Metabolism, Department of Internal Medicine, Landspitali-University Hospital, Reykjavik, Iceland.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Sigurdsson
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland.
authors.forename: Gudny
authors.initials: G
authors.lastname: Eiriksdottir
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland.
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.affiliation: Orthopedics, University Hospital, Malmo, Sweden.
authors.forename: Brynjolfur Y
authors.initials: BY
authors.lastname: Jonsson
authors.affiliation: LEDB, National Institute on Aging, Bethesda, MD, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Garcia
authors.affiliation: LEDB, National Institute on Aging, Bethesda, MD, USA.
authors.forename: Binbing
authors.initials: B
authors.lastname: Yu
authors.affiliation: UTHSC School of Public Health, Houston, TX, USA.
authors.forename: Asha S
authors.initials: AS
authors.lastname: Kapadia
authors.affiliation: UTHSC School of Public Health, Houston, TX, USA.
authors.forename: Wendell C
authors.initials: WC
authors.lastname: Taylor
authors.affiliation: UTHSC School of Public Health, Houston, TX, USA.
authors.forename: Beatrice J
authors.initials: BJ
authors.lastname: Selwyn
authors.affiliation: Icelandic Heart Association, Kopavogur, Iceland; Cardiovascular Genetics, University of Iceland, Reykjavik, Iceland.
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.affiliation: Neuroepidemiology Section, National Institute on Aging, Bethesda, MD, USA.
authors.forename: Lenore J
authors.initials: LJ
authors.lastname: Launer
authors.affiliation: LEDB, National Institute on Aging, Bethesda, MD, USA.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
mesh_terms: D015502:Absorptiometry, Photon; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D015331:Cohort Studies; D004198:Disease Susceptibility; D005260:Female; D005272:Femur Neck; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D057566:Self Report; D012737:Sex Factors; D014057:Tomography, X-Ray Computed
keywords: Bone mineral density; bone strength; elderly; fracture; quantitative computerized tomography
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