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01.12.2020 | Original Article

Association between osteoporotic femoral neck fractures and DXA-derived 3D measurements at lumbar spine: a case-control study

verfasst von: Mirella López Picazo, Ludovic Humbert, Renaud Winzenrieth, Silvana Di Gregorio, Miguel A. González Ballester, Luis M. del Río Barquero

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2020

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Abstract

Summary

A case-control study assessing the association of DXA-derived 3D measurements at lumbar spine with osteoporotic hip fractures was performed. Stronger association was found between transcervical hip fractures and integral (AUC = 0.726), and cortical (AUC = 0.696) measurements at the lumbar spine compared with measurements at the trabecular bone (AUC = 0.617); although femur areal bone mineral density (aBMD) remains the referent measurement for hip fracture risk evaluation (AUC = 0.838).

Purpose

The aim of the present study was to evaluate the association between DXA-derived 3D measurements at lumbar spine and osteoporotic hip fractures.

Methods

We analyzed a case-control database composed by 61 women with transcervical hip fractures and 61 age-matched women without any type of fracture. DXA scans at lumbar spine were acquired, and areal bone mineral density (aBMD) was measured. Integral, trabecular and cortical volumetric BMD (vBMD), cortical thickness, and cortical surface BMD (sBMD) at different regions of interest were assessed using a DXA-based 3D modeling software. Descriptive statistics, tests of difference, odds ratio (OR), and area under the receiver operating curve (AUC) were used to compare hip fracture and control groups.

Results

Integral vBMD, cortical vBMD, cortical sBMD, and cortical thickness were the DXA-derived 3D measurements at lumbar spine that showed the stronger association with transcervical hip fractures, with AUCs in the range of 0.685–0.726, against 0.670 for aBMD. The highest AUC (0.726) and OR (2.610) at the lumbar spine were found for integral vBMD at the posterior vertebral elements. Significantly, lower AUC (0.617) and OR (1.607) were found for trabecular vBMD at the vertebral body. Overall, total femur aBMD remains the DXA-derived measurement showing the highest AUC (0.838) and OR (6.240).

Conclusion

This study showed the association of DXA-derived measurements at lumbar spine with transcervical hip fractures. A strong association between vBMD at the posterior vertebral elements and transcervical hip fractures was observed, probably because of global deterioration of the cortical bone. Further studies should be carried out to investigate on the relative risk of transcervical fracture in patients with long-term cortical structural deterioration.

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Titel: Association between osteoporotic femoral neck fractures and DXA-derived 3D measurements at lumbar spine: a case-control study
verfasst von: Mirella López Picazo
Ludovic Humbert
Renaud Winzenrieth
Silvana Di Gregorio
Miguel A. González Ballester
Luis M. del Río Barquero
Publikationsdatum: 01.12.2020
Verlag: Springer London
Erschienen in: Archives of Osteoporosis / Ausgabe 1/2020
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-019-0680-4

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Association between osteoporotic femoral neck fractures and DXA-derived 3D measurements at lumbar spine: a case-control study

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