Combination of hip geometry mechanics and fracture risk assessment tool to predict fracture risk in middle-aged and elderly women / 中国组织工程研究

ABSTRACT

BACKGROUND: Hip geometric mechanics indicates a mechanical study of hip structure (cortical thickness) based on dual energy X-ray absorptiometry images, which is a better compensation for the deviation of bone density. The fracture risk assessment tool (FRAX) can combine fracture probability with multiple clinical risk factors and bone density of the femoral neck to predict the probability of hip fracture within 10 years and the probability of major osteoporotic fractures (spine, forearm, hip or shoulder fracture). OBJECTIVE: To analyze the hip geometry mechanics and the correlation between the FRAX@ tool and fractures in middle-aged and elderly women, and to explore the clinical significance of the combination method to predict the risk of fragility fracture in middle-aged and elderly women. METHODS: A retrospective study of 1 089 middle-aged female subjects was conducted. According to the questionnaire, there were 225 cases of fractures and 864 cases of non-fractures. Bone mineral density was measured using a dual-energy X-ray absorptiometry, and hip geometrical parameters were analyzed using HSA software cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), cross-sectional modulus (Z), cortical bone thickness (Cort) and the buckling ratio (BR) value. The FRAX@ tool was used to calculate the fracture rate at the main site and hip fracture rate over the next 10 years. The study was approved by the Ethics Committee of Fujian Institute of Traditional Chinese Medicine. RESULTS AND CONCLUSION: The age of the fracture group was significantly higher than that of the non-fracture group. The hip geometrical parameters of the two groups were compared lumbar vertebra bone density, femoral neck bone density, CSA, CSMI, Cort, Z were significantly higher in the non-fracture group than the fracture group, while BR was lower in the non-fracture group than the fracture group. Logistic regression analysis of hip geometry mechanics indicated that Cort was a possible protective factor for fracture (odds ratio=0.000, 95% confidence interval 0.000-0.000). FRAX calculation and analysis of different age groups indicated that the fracture rate at the main site and hip fracture rate of the fracture group were significantly higher than those of the non-fracture group in the next 10 years. In conclude, there is a significant correlation between hip geometric mechanics and fracture. The Cort of the femoral neck is a possible protective factor for fracture, and FRAX@ has a clinical guiding value for predicting fracture. The combination of the two can better predict osteoporotic fracture.