Total Hip Bone Area Affects Fracture Prediction With FRAX® in Canadian White Women

The Journal of Clinical Endocrinology and Metabolism
William D LeslieJohn A Kanis

Abstract

Areal bone mineral density (BMD) measurements are confounded by skeletal size. Hip BMD is an input to the FRAX® tool (Centre for Metabolic Bone Diseases, University of Sheffield, United Kingdom), but it is unknown whether performance is affected by hip area. To examine whether fracture prediction by FRAX® is affected by hip area. Cohort study using a population-based BMD registry. A total of 58,108 white women aged ≥40 years. Incident major osteoporotic fracture (MOF; n = 4913) and hip fracture (n = 1369), stratified by total hip area quintile, before and after adjustment for hip axis length (HAL). Smaller hip area was associated with younger age and lower FRAX® scores, whereas incident fractures were greater in those with larger hip area (P for trend < 0.001). Larger hip area quintile increased risk for MOF and hip fracture when adjusted for FRAX® score with BMD (P for trend < 0.001). Each standard deviation increase in hip area was associated with greater risk for incident MOF [adjusted hazard ratio (HR), 1.08; 95% confidence interval (CI), 1.05 to 1.11] and hip fracture (HR, 1.16; 95% CI, 1.11 to 1.21), but not after adjustment for HAL. FRAX® with BMD underestimated MOF risk in the largest hip area quintile and underestimate...Continue Reading

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Feb 5, 2019·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Erin Mr BigelowKarl J Jepsen
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