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Peripheral quantitative computed tomography measures are associated with adult fracture risk: the Hertfordshire Cohort Study

Peripheral quantitative computed tomography measures are associated with adult fracture risk: the Hertfordshire Cohort Study
Peripheral quantitative computed tomography measures are associated with adult fracture risk: the Hertfordshire Cohort Study
Peripheral quantitative computed tomography (pQCT) captures novel aspects of bone geometry that may contribute to fracture risk and offers the ability to measure both volumetric bone mineral density (vBMD) and a separation of trabecular and cortical compartments of bone, but longitudinal data relating measures obtained from this technique to incident fractures are lacking. Here we report an analysis from the Hertfordshire Cohort Study, where we were able to study associations between measures obtained from pQCT and DXA in 182 men and 202 women aged 60-75 years at baseline with incident fractures over 6 years later. Among women, radial cortical thickness (HR 1.72, 95% CI 1.16, 2.54, p=0.007) and cortical area (HR 1.91, 95% CI 1.27, 2.85, p=0.002) at the 66% slice were both associated with incident fractures; these results remained significant after adjustment for confounders (age, BMI, social class, cigarette smoking and alcohol consumption, physical activity, dietary calcium, HRT and years since menopause). Further adjustment for aBMD made a little difference to the results. At the tibia, cortical area (HR 1.58, 95% CI 1.10, 2.28, p=0.01), thickness (HR 1.49, 95% CI 1.08, 2.07, p=0.02) and density (HR 1.64, 95% CI 1.18, 2.26, p=0.003) at the 38% site were all associated with incident fractures with the cortical area and density relationships remaining robust to adjustment for the confounders listed above. Further adjustment for aBMD at this site did lead to attenuation of relationships. Among men, tibial stress-strain index (SSI) was predictive of incident fractures (HR 2.30, 95% CI 1.28, 4.13, p=0.005). Adjustment for confounding variables and aBMD did not render this association non-significant. In conclusion, we have demonstrated relationships between measures of bone size, density and strength obtained by pQCT and incident fracture. These relationships were attenuated but in some cases remained significant after adjustment for BMD measures obtained by DXA, suggesting that some additional information may be conferred by this assessment.
bone, epidemiology, fracture
8756-3282
13-17
Dennison, E.M.
ee647287-edb4-4392-8361-e59fd505b1d1
Jameson, K.A.
d5fb142d-06af-456e-9016-17497f94e9f2
Edwards, M.H.
b81ff294-1d16-4a1b-af14-9374c5989d4c
Denison, H.J.
dbe5f26d-6323-4477-9519-c826869b7810
Aihie-Sayer, A.
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, E.M.
ee647287-edb4-4392-8361-e59fd505b1d1
Jameson, K.A.
d5fb142d-06af-456e-9016-17497f94e9f2
Edwards, M.H.
b81ff294-1d16-4a1b-af14-9374c5989d4c
Denison, H.J.
dbe5f26d-6323-4477-9519-c826869b7810
Aihie-Sayer, A.
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6

Dennison, E.M., Jameson, K.A., Edwards, M.H., Denison, H.J., Aihie-Sayer, A. and Cooper, C. (2014) Peripheral quantitative computed tomography measures are associated with adult fracture risk: the Hertfordshire Cohort Study. Bone, 64, 13-17. (doi:10.1016/j.bone.2014.03.040). (PMID:24680720)

Record type: Article

Abstract

Peripheral quantitative computed tomography (pQCT) captures novel aspects of bone geometry that may contribute to fracture risk and offers the ability to measure both volumetric bone mineral density (vBMD) and a separation of trabecular and cortical compartments of bone, but longitudinal data relating measures obtained from this technique to incident fractures are lacking. Here we report an analysis from the Hertfordshire Cohort Study, where we were able to study associations between measures obtained from pQCT and DXA in 182 men and 202 women aged 60-75 years at baseline with incident fractures over 6 years later. Among women, radial cortical thickness (HR 1.72, 95% CI 1.16, 2.54, p=0.007) and cortical area (HR 1.91, 95% CI 1.27, 2.85, p=0.002) at the 66% slice were both associated with incident fractures; these results remained significant after adjustment for confounders (age, BMI, social class, cigarette smoking and alcohol consumption, physical activity, dietary calcium, HRT and years since menopause). Further adjustment for aBMD made a little difference to the results. At the tibia, cortical area (HR 1.58, 95% CI 1.10, 2.28, p=0.01), thickness (HR 1.49, 95% CI 1.08, 2.07, p=0.02) and density (HR 1.64, 95% CI 1.18, 2.26, p=0.003) at the 38% site were all associated with incident fractures with the cortical area and density relationships remaining robust to adjustment for the confounders listed above. Further adjustment for aBMD at this site did lead to attenuation of relationships. Among men, tibial stress-strain index (SSI) was predictive of incident fractures (HR 2.30, 95% CI 1.28, 4.13, p=0.005). Adjustment for confounding variables and aBMD did not render this association non-significant. In conclusion, we have demonstrated relationships between measures of bone size, density and strength obtained by pQCT and incident fracture. These relationships were attenuated but in some cases remained significant after adjustment for BMD measures obtained by DXA, suggesting that some additional information may be conferred by this assessment.

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e-pub ahead of print date: 27 March 2014
Published date: July 2014
Keywords: bone, epidemiology, fracture
Organisations: Faculty of Medicine

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Local EPrints ID: 367096
URI: http://eprints.soton.ac.uk/id/eprint/367096
ISSN: 8756-3282
PURE UUID: 4f1266a8-26ac-4866-9e2a-bfcaf8047077
ORCID for E.M. Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 28 Jul 2014 15:30
Last modified: 18 Feb 2021 16:48

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Contributors

Author: E.M. Dennison ORCID iD
Author: K.A. Jameson
Author: M.H. Edwards
Author: H.J. Denison
Author: A. Aihie-Sayer
Author: C. Cooper ORCID iD

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