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Cluster analysis of bone microarchitecture from high resolution peripheral quantitative computed tomography demonstrates two separate phenotypes associated with high fracture risk in men and women

Cluster analysis of bone microarchitecture from high resolution peripheral quantitative computed tomography demonstrates two separate phenotypes associated with high fracture risk in men and women
Cluster analysis of bone microarchitecture from high resolution peripheral quantitative computed tomography demonstrates two separate phenotypes associated with high fracture risk in men and women
Osteoporosis is a major healthcare problem which is conventionally assessed by dual energy X-ray absorptiometry (DXA). New technologies such as high resolution peripheral quantitative computed tomography (HRpQCT) also predict fracture risk. HRpQCT measures a number of bone characteristics that may inform specific patterns of bone deficits. We used cluster analysis to define different bone phenotypes and their relationships to fracture prevalence and areal bone mineral density (BMD). 177 men and 159 women, in whom fracture history was determined by self-report and vertebral fracture assessment, underwent HRpQCT of the distal radius and femoral neck DXA. Five clusters were derived with two clusters associated with elevated fracture risk. “Cluster 1” contained 26 women (50.0% fractured) and 30 men (50.0% fractured) with a lower mean cortical thickness and cortical volumetric BMD, and in men only, a mean total and trabecular area more than the sex-specific cohort mean. “Cluster 2” contained 20 women (50.0% fractured) and 14 men (35.7% fractured) with a lower mean trabecular density and trabecular number than the sex-specific cohort mean. Logistic regression showed fracture rates in these clusters to be significantly higher than the lowest fracture risk cluster [5] (p < 0.05). Mean femoral neck areal BMD was significantly lower than cluster 5 in women in cluster 1 and 2 (p < 0.001 for both), and in men, in cluster 2 (p < 0.001) but not 1 (p = 0.220). In conclusion, this study demonstrates two distinct high risk clusters in both men and women which may differ in etiology and response to treatment. As cluster 1 in men does not have low areal BMD, these men may not be identified as high risk by conventional DXA alone.
8756-3282
131-137
Edwards, M.H.
8d92e1ef-8d4d-4efa-a183-305cd9ca1125
Robinson, D.E.
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Ward, K.A.
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Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Walker-Bone, K.
ad7d1336-ed2c-4f39-ade5-da84eb412109
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, E.
ee647287-edb4-4392-8361-e59fd505b1d1
Edwards, M.H.
8d92e1ef-8d4d-4efa-a183-305cd9ca1125
Robinson, D.E.
a89b4176-6b64-4be4-bbca-6b3c630f5570
Ward, K.A.
39bd4db1-c948-4e32-930e-7bec8deb54c7
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Walker-Bone, K.
ad7d1336-ed2c-4f39-ade5-da84eb412109
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, E.
ee647287-edb4-4392-8361-e59fd505b1d1

Edwards, M.H., Robinson, D.E., Ward, K.A., Javaid, M.K., Walker-Bone, K., Cooper, C. and Dennison, E. (2016) Cluster analysis of bone microarchitecture from high resolution peripheral quantitative computed tomography demonstrates two separate phenotypes associated with high fracture risk in men and women. Bone, 88, 131-137. (doi:10.1016/j.bone.2016.04.025). (PMID:27130873)

Record type: Article

Abstract

Osteoporosis is a major healthcare problem which is conventionally assessed by dual energy X-ray absorptiometry (DXA). New technologies such as high resolution peripheral quantitative computed tomography (HRpQCT) also predict fracture risk. HRpQCT measures a number of bone characteristics that may inform specific patterns of bone deficits. We used cluster analysis to define different bone phenotypes and their relationships to fracture prevalence and areal bone mineral density (BMD). 177 men and 159 women, in whom fracture history was determined by self-report and vertebral fracture assessment, underwent HRpQCT of the distal radius and femoral neck DXA. Five clusters were derived with two clusters associated with elevated fracture risk. “Cluster 1” contained 26 women (50.0% fractured) and 30 men (50.0% fractured) with a lower mean cortical thickness and cortical volumetric BMD, and in men only, a mean total and trabecular area more than the sex-specific cohort mean. “Cluster 2” contained 20 women (50.0% fractured) and 14 men (35.7% fractured) with a lower mean trabecular density and trabecular number than the sex-specific cohort mean. Logistic regression showed fracture rates in these clusters to be significantly higher than the lowest fracture risk cluster [5] (p < 0.05). Mean femoral neck areal BMD was significantly lower than cluster 5 in women in cluster 1 and 2 (p < 0.001 for both), and in men, in cluster 2 (p < 0.001) but not 1 (p = 0.220). In conclusion, this study demonstrates two distinct high risk clusters in both men and women which may differ in etiology and response to treatment. As cluster 1 in men does not have low areal BMD, these men may not be identified as high risk by conventional DXA alone.

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Accepted/In Press date: 25 April 2016
e-pub ahead of print date: 26 April 2016
Published date: July 2016
Organisations: Faculty of Medicine

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Local EPrints ID: 396511
URI: http://eprints.soton.ac.uk/id/eprint/396511
ISSN: 8756-3282
PURE UUID: ac430c78-d734-4e36-b0cc-0ec4c40fb003
ORCID for K.A. Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for K. Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for E. Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 10 Jun 2016 09:20
Last modified: 18 Feb 2021 17:26

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Contributors

Author: M.H. Edwards
Author: D.E. Robinson
Author: K.A. Ward ORCID iD
Author: M.K. Javaid
Author: K. Walker-Bone ORCID iD
Author: C. Cooper ORCID iD
Author: E. Dennison ORCID iD

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