Background It is well documented that low bone mineral density is a predictor of hip fracture. 1 Hip structural analysis (HSA) is also useful for predicting fractures in women. 2,3 It is important to better understand predictors of fractures in men, which like women may include HSA. To date, studies have focused on populations with specific age ranges or co-morbidities and tend to use small sample sizes when analysing the relationship between HSA and fracture in males. 4,5
Objectives To investigate the association between HSA and fractures in a large cohort of men.
Methods Data was collected from male patients referred to a District General Hospital for DXA scanning between April 2004 and September 2010. Numerous variables were recorded including: age, BMI, traditional risk factors for osteoporosis (OP), social deprivation score (IMD) and HSA (Table1). Patients were divided into groups depending on hip fracture status and baseline characteristics were compared using a T-test and Chi2 for continuous and categorical variables respectively. HSA measurements were compared between groups using a logistic regression model and repeated adjusting for possible confounders.
Results 2,564 males were included in the study, of these 738 (28.8%) had sustained a previous hip fracture. The mean age of the fracture and non-fracture group was 66.4 years (SD 13.2) and 64.4 years (SD 13.5) respectivley (p=1). The mean BMI was 24.2kg/m2 (SD 2.7) and 26.9kg/m2(SD 4.5) in the fracture and non-fracture groups respectively, (p<0.05). Mean IMD in the fracture group was 19.5 (SD 0.6) and 18.2 (SD 0.3) in the non-fracture group. Odds ratio for logistic regression anaylsis for comparison of HSA between the groups is shown in Table1.
Conclusions This study has shown that there are structural differences in the hip of males who have sustained a hip fracture compared to those who have not. Geometrical differences included a weaker, shorter, wider femoral neck as shown by SI, D2 and D3 and y respectively; in addition to a reduced cross sectional area (CSA). The results of this study correlate well with findings in women.2 Further research in alternative cohorts is required to validate this.
J Bone Miner Res. 2005 Jul;20(7):1185-94
Osteoporos Int. 2006;17(4):593-9
Osteoporos Int. 2010 June; 21(6): 919–929
Eur J Endocrinol. 2007 Jan;156(1):123-7
J Bone Miner Res. 2005 Oct;20(10):1820-7
Disclosure of Interest None Declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.