title: Hip structural changes and fracture risk in osteopenia and osteoporosis.
abstract: OBJECTIVE
  Although bone mineral density (BMD) is an important predictor of hip fracture, there is a large overlap of BMD values between those who fracture their hips and those who do not. The aim of this study was to evaluate differences in the structural parameters of the hip in patients with osteopenia and osteoporosis in the hip region and to assess their relationship with osteoporotic fracture risk, age and gender.
  
  
  METHODS
  In this observational retrospective study, 150 patients with osteopenia (100 postmenopausal women and 50 men ≥50 years of age) and 125 patients with osteoporosis in the hip (100 postmenopaussal women and 25 men ≥50 years of age) were included. In addition to densitometry measurements by DEXA (Dual Energy X-ray Absorbimetry), structural variables were determined using the Hip Strength Analysis program (HSA).
  
  
  RESULTS
  In logistic regression analyses, the femoral neck BMD (odds ratio (OR), 2.6; 95% Confidence Interval (CI) 1.8-3.8), age (OR per 10 years 1.4; 95% CI, 1.1-1.9), femoral neck shaft angle (NSA) (OR 1.5; 95% CI, 1.2-2.1), Femur Strength Index (FSI) (OR 1.6; 95% CI 1.3-2.2), and Cross sectional area (CSA) (OR 1.6; 95% CI 1.2-2.1) were all associated with osteoporotic fractures in women and men. Osteopenic patients had smaller femoral neck-shaft angles (NSA) compared to osteoporotic patients (p<0.05). This angle was larger in women (p<0.05); and women had decreased (FSI) (p<0.001) and CSA (p<0.05), which cause increased fracture risk.
  
  
  CONCLUSIONS
  Spatial distribution of bone tissue is a useful determinant of fracture risk.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Esenyel
authors.affiliation: Department of Nuclear Medicine, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Ozen
authors.affiliation: Department of Orthopedy and Tarumatology, Okmeydanı Education and Research Hospital, Istanbul, Turkey.
authors.forename: Cem Zeki
authors.initials: CZ
authors.lastname: Esenyel
authors.affiliation: Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Rezvani
authors.affiliation: Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Mustafa Akif
authors.initials: MA
authors.lastname: Sariyildiz
authors.affiliation: Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Onder
authors.initials: O
authors.lastname: Ergin
keywords: BMD; Osteoporosis; fracture risk; hip geometry