Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
The association between increasing body mass index (BMI), increasing bone mineral density (BMD) and lower hip fracture risk has been demonstrated by previous research. Studies have implicated variations of proximal femur shape in hip fracture risk. Research has indicated that BMI affects hip fracture risk by its associations with both BMD and proximal femur shape.
This study aims to investigate if variations of proximal femur shape associated with BMI are associated with hip fracture risk, independent of BMD, in a large population of women aged over 50 years.
Methods:
Data of women aged over 50 years that attended for a DXA scan at a UK hospital were collated. The following Hip Structural Analysis (HSA) measurements were used to characterise the shape of the proximal femur: distance from centre of femoral head to centre of femoral neck (d1), distance from centre of femoral head to inter-trochanteric line (d2), mean femoral neck diameter (d3), distance from centre of mass of femoral neck to superior neck margin (y), hip axis length (HAL), cross-sectional moment of inertia (CSMI) and the neck/shaft angle. Multiple regression analysis was used to investigate for associations between BMI and each HSA measurement, adjusted for age, femoral neck BMD and significant osteoporosis risk factors. Logistic regression analysis modelling was used to investigate for associations between previous contralateral hip fracture and each HSA measurement, adjusted for age, BMI, femoral neck BMD and significant osteoporosis risk factors.
Results:
Data of 8,788 women was analysed. Analysis revealed that a wider (d3, y) and shorter (d1) femoral neck with increased cortical thickness (CSA, CSMI) were associated with a clear significant relationship with increasing BMI (tables 1 and 2). Further analysis revealed that proximal femur shape was not significantly associated with previous contralateral hip fracture (table 2).
Conclusion:
This study of a large population of older women identified that a wider and shorter femoral neck with increased cortical thickness was associated with increasing BMI; however, variations of proximal femur shape associated with BMI were not associated with previous hip fracture status.
|
|
BMI category (Kg/m2) |
||||
|
|
<19 |
19-25 |
25-30 |
30-35 |
>35 |
|
Number in category |
552 |
3046 |
3149 |
1421 |
620 |
|
Mean BMI/Kg/m2 (SD) |
18.56 (1.11) |
22.89 (1.36) |
27.26 (1.41) |
32.09 (1.40) |
38.46 (3.04) |
|
Mean age/years (SD) |
67.99 (10.24) |
66.61 (9.82) |
67.35 (9.25) |
67.39 (8.98) |
65.07 (8.76) |
|
Mean number of OP risk factors (SD) |
2.89 (1.52) |
2.40 (1.31) |
2.44 (1.32) |
2.40 (1.33) |
2.40 (1.32) |
|
Femoral neck BMD (SD) |
0.73 (0.12) |
0.79 (0.12) |
0.83 (0.12) |
0.86 (0.13) |
0.90 (0.15) |
|
Proportion with previous hip fracture/% |
5.62 |
2.95 |
2.95 |
3.24 |
2.41 |
|
HAL/mm (SD) |
106.07 (7.25) |
105.69 (6.34) |
105.68 (6.08) |
105.90 (5.96) |
106.19 (5.82) |
|
CSMI/m4 (SD) |
8.07 (2.12) |
8.82 (2.22) |
9.27 (2.53) |
9.56 (2.64) |
9.91 (2.88) |
|
CSA/mm2 (SD) |
109.76 (19.92) |
121.56 (19.96) |
126.99 (21.36) |
131.88 (23.37) |
137.38 (25.48) |
|
d1/mm (SD) |
16.83 (3.25) |
16.27 (3.19) |
15.92 (3.26) |
15.61 (3.23) |
15.86 (3.33) |
|
d2/mm (SD) |
47.68 (6.31) |
48.08 (5.71) |
48.48 (5.62) |
48.75 (5.75) |
48.88 (5.90) |
|
d3/mm (SD) |
32.87 (2.84) |
32.90 (2.50) |
33.17 (2.55) |
33.23 (2.58) |
33.18 (2.65) |
|
Y/mm (SD) |
16.95 (1.82) |
16.81 (1.48) |
16.99 (1.57) |
17.09 (1.60) |
17.05 (1.69) |
|
Neck/shaft angle/o |
125.93 (5.41) |
125.02 (5.28) |
124.88 (5.22) |
124.84 (5.47) |
124.63 (5.51) |
Table 1 – BMI categories and mean age, number of OP risk factors, mean femoral neck BMD, proportion that have previously sustained a hip fracture and mean HSA measurements
|
HSA measurement |
Coefficient against BMI |
p-value |
Coefficient against previous hip fracture |
p-value |
|
HAL/mm (SD) |
-0.02 |
0.764 |
-0.06 |
0.61 |
|
CSMI/m4 (SD) |
0.07 |
0.02 |
-0.09 |
0.78 |
|
CSA/mm2 (SD) |
0.01 |
0.01 |
0.04 |
0.53 |
|
d1/mm (SD) |
-0.15 |
<0.01 |
-0.20 |
0.21 |
|
d2/mm (SD) |
0.01 |
0.26 |
-0.01 |
0.92 |
|
d3/mm (SD) |
0.13 |
<0.01 |
0.58 |
0.06 |
|
y/mm |
0.32 |
<0.01 |
0.08 |
0.10 |
|
Neck/shaft angle/o (SD) |
-0.01 |
0.24 |
-0.30 |
0.79 |
Table 2 – coefficient and p-value of each HSA measurement against BMI, adjusted for age, number of OP risk factors and femoral neck BMD; coefficient and p-value of each HSA measurement against previous hip fracture, adjusted for age, number of OP risk factors, BMI and femoral neck BMD
Disclosure:
A. Oldroyd,
None;
M. Bukhari,
None.
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