title: Non-invasive Assessment of Lower Limb Geometry and Strength Using Hip Structural Analysis and Peripheral Quantitative Computed Tomography: A Population-Based Comparison.
abstract: Hip fracture is the most significant complication of osteoporosis in terms of mortality, long-term disability and decreased quality of life. In the recent years, different techniques have been developed to assess lower limb strength and ultimately fracture risk. Here we examine relationships between two measures of lower limb bone geometry and strength; proximal femoral geometry and tibial peripheral quantitative computed tomography. We studied a sample of 431 women and 488 men aged in the range 59-71 years. The hip structural analysis (HSA) programme was employed to measure the structural geometry of the left hip for each DXA scan obtained using a Hologic QDR 4500 instrument while pQCT measurements of the tibia were obtained using a Stratec 2000 instrument in the same population. We observed strong sex differences in proximal femoral geometry at the narrow neck, intertrochanteric and femoral shaft regions. There were significant (p < 0.001) associations between pQCT-derived measures of bone geometry (tibial width; endocortical diameter and cortical thickness) and bone strength (strength strain index) with each corresponding HSA variable (all p < 0.001) in both men and women. These results demonstrate strong correlations between two different methods of assessment of lower limb bone strength: HSA and pQCT. Validation in prospective cohorts to study associations of each with incident fracture is now indicated.
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.
authors.forename: A E
authors.initials: AE
authors.lastname: Litwic
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.
authors.forename: M
authors.initials: M
authors.lastname: Clynes
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.
authors.forename: H J
authors.initials: HJ
authors.lastname: Denison
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.
authors.forename: K A
authors.initials: KA
authors.lastname: Jameson
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.
authors.forename: M H
authors.initials: MH
authors.lastname: Edwards
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.|Institute for Ageing and Institute of Health & Society, Newcastle University, Callaghan, Australia.
authors.forename: A A
authors.initials: AA
authors.lastname: Sayer
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.
authors.forename: P
authors.initials: P
authors.lastname: Taylor
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK.|NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
authors.forename: C
authors.initials: C
authors.lastname: Cooper
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton) Southampton General Hospital, Southampton, SO16 6YD, UK. emd@mrc.soton.ac.uk.|Victoria University of Wellington, Wellington, New Zealand. emd@mrc.soton.ac.uk.
authors.forename: E M
authors.initials: EM
authors.lastname: Dennison
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging*; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Epidemiology; Hip structural analysis; Osteoporosis; Peripheral quantitative computed tomography