title: Increased Cortical Porosity in Older Men With Fracture.
abstract: Cortical porosity increases with age and affects bone strength, but its association with fracture in older men is unknown. The aim of this study was to investigate whether cortical porosity is associated with prevalent fractures in older men. A subsample of 456 men aged 80.2 ± 3.5 (mean ± SD) years, with available high-resolution peripheral quantitative computed tomography measurements at the tibia from the 5-year follow-up exam, was drawn from the prospective MrOS Gothenburg study. Dual-energy X-ray absorptiometry was used to measure areal bone mineral density (aBMD). Data on physical activity, calcium intake, medications, diseases, and smoking were collected on questionnaires at the follow-up exam. Of 87 men (19.1%) with fracture at or after age 50 years (all fracture group), 52 (11.4%) had had a self-reported fracture before the baseline exam and 35 (7.7%) had had an X-ray-verified fracture between baseline and follow-up. Men in the all-fracture group and in the X-ray-verified group had 15.8% (13.2% ± 4.9% versus 11.4% ± 3.8%; p < 0.001) and 21.6% (14.1% ± 5.2% versus 11.6% ± 3.9%; p < 0.01) higher cortical porosity, respectively, than men in the nonfracture group. The independent associations between bone microstructure parameters and fracture were tested using multivariate logistic regression with age, height, weight, calcium intake, smoking, physical activity, medications, and diseases as covariates. Cortical porosity was independently associated with any fracture (reported or X-ray-verified; OR per SD increase 1.49; 95% confidence interval (CI), 1.17 to 1.90) and with any X-ray-verified fracture alone (OR 1.73; 95% CI, 1.23 to 2.42). Including aBMD (spine or hip, respectively) in the multivariate logistic regression above revealed that cortical porosity was associated with any fracture (OR 1.54; 95% CI, 1.17 to 2.01) and with X-ray-verified fracture alone (OR 1.49; 95% CI, 1.00 to 2.22). Cortical porosity was associated with prevalence of fracture even after adjustment for aBMD.
authors.affiliation: Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.|Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sundh
authors.affiliation: Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.|Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Mellström
authors.affiliation: Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.|Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, and Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Karlsson
authors.affiliation: Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Ohlsson
authors.affiliation: Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.|Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Mattias
authors.initials: M
authors.lastname: Lorentzon
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000473:pathology; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000473:pathology*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D016062:Porosity; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013548:Sweden; D014057:Tomography, X-Ray Computed
keywords: BONE MINERAL DENSITY; CORTICAL POROSITY; FRACTURE; MEN; OSTEOPOROSIS