Reference indices of hip structural analysis in Ukrainian women
Background. Nowadays, a comprehensive assessment of osteoporosis and the risk of osteoporotic fractures involves the combine use of bone mineral density (BMD), 10-year probability of major osteoporotic fractures (Fracture Risk Assessment Tool), Trabecular Bone Score, and parameters of hip structural analysis. In recent years, reference data on the three above-mentioned methods have been developed for the Ukrainian population, but there are no data on the latest methodology. The objective of the study was to assess the age characteristics of hip structural analysis parameters in Ukrainian women and to offer their reference values for use in clinical practice. Materials and methods. Using the dual energy X-ray absorptiometry method, we examined 690 healthy women aged 20–89 years without osteoporosis and other clinically significant diseases and conditions affecting the bone metabolism, without other accompanying pathology of hip joint. Results. The results of the study showed a significant effect of age on femoral strength index (FSI), cross-sectional moment of inertia (CSMI), cross-sectional area (CSA), distance from center of femoral head to center of femoral neck (d1), distance from center of femoral head to inter-trochanteric line (d2), mean femoral neck diameter (d3), distance from center of mass of femoral neck to superior neck margin (y), shaft angle (a) and hip axis length (HAL) indices, but not on parameters of neck/shaft angle (q). A significant decrease of FSI with age was established on the background on increase of CSMI, CSA and HAL parameters. Indices of height and body weight were reliably related with parameters of CSMI, CSA and HAL. FSI was significantly related to the body weight, but not to the height. In addition, it reliably correlated with BMD measured at femoral neck and lesser at total hip and lumbar spine. The HAL did not significant correlate with any of the measured BMD, which confirms its independent role in prediction of hip fractures risk. Conclusions. The obtained normative indices of the hip structural analysis in healthy Ukrainian women can be used for a comprehensive assessment of bone status and hip fractures risk.
Full Text:PDF (Українська)
Povoroznyuk VV, Grigorieva NV, Orlik TV, Nishkumaj OI, Dzerovich NI, Balatska NI. Osteoporoz v praktike vracha-internista [Osteoporosis in the practice of an internist doctor]. Kyiv: Ekspres; 2014. 198 р. (in Russian).
Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop Jan. 2011;45(1):15-22. doi: 10.4103/0019-5413.73656 .
Filipov O. Epidemiology and social burden of the femoral neck fractures. J of IMAB. 2014;20(4):516-518. doi: 10.5272/jimab.2014204.516.
Tucker A, Donnelly KJ, McDonald S, et al. The changing face of fractures of the hip in Northern Ireland: a 15-year review. Bone Joint J. 2017 Sep;99-B(9):1223-1231. doi: 10.1302/0301-620X.99B9.BJJ-2016-1284.R1.
ISCD Official Posotions – Adult. Available from: https://www.iscd.org/official-positions/2015-iscd-official-positions-adult.
Punda M, Grazio S. Bone densitometry – the gold standard for diagnosis of osteoporosis. Reumatizam. 2014;61(2):70-4. PMID: 25427398. (in Croatian).
Blake GM, Fogelman I. Role of dual-energy X-ray absorptiometry in the diagnosis and treatment of osteoporosis. J Clin Densitom. 2007 Jan-Mar;10(1):102-10. doi: 10.1016/j.jocd.2006.11.001.
FRAX - Fracture Risk Assessment Tool. Available from: https://www.sheffield.ac.uk/FRAX/tool.jsp?lang=en
Povoroznyuk VV, Grigorieva NV. The role of FRAX in predicting the risk of fractures. Problemy osteologii'. 2012;(1):3-15. (In Ukrainian).
Hans D, Goertzen AL, Krieg MA, Leslie WD. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res. 2011 Nov;26(11):2762-9. doi: 10.1002/jbmr.499.
Shevroja E, Lamy O, Kohlmeier L, Koromani F, Rivadeneira F, Hans D. Use of Trabecular Bone Score (TBS) as a Complementary Approach to Dual-energy X-ray Absorptiometry (DXA) for Fracture Risk Assessment in Clinical Practice. J Clin Densitom. 2017 Jul - Sep;20(3):334-345. doi: 10.1016/j.jocd.2017.06.019.
Beck TJ. Hip Structural Analysis (HSA) Program (BMD and Structural Geometry Methodology) As Used to Create NHANES III Dataset. Baltimore, MD: Johns Hopkins University, School of Medicine; October 29, 2002. 11 р.
Faulkner KG, Wacker WK, Barden HS, et al. Femur strength index predicts hip fracture independent of bone density and hip axis length Osteoporos Int. 2006;(17):593-599. doi: 10.1007/s00198-005-0019-4.
Boudreaux RD, Sibonga JD. Advanced Hip Analysis: Simple Geometric Measurements Predict Hip Fracture Beyond Bone Mineral Density. TOJ. 2015;1(2):109-122. doi: 10.18600/toj.010212.
Muschitz Ch, Milassin L, Patsch J, et al. DXA and QCT Geometric Structural Measurements of Proximal Femoral Strength. Available from: http://docplayer.net/48276073-Dxa-and-qct-geometric-structural-measurements-of-proximal-femoral-strength.html
Beck TJ, Looker AC, Ruff CB, Sievanen H, Wahner HW. Structural trends in the aging femoral neck and proximal shaft: analysis of the Third National Health and Nutrition Examination Survey dual-energy X-ray absorptiometry data. J Bone Miner Res. 2000 Dec;15(12):2297-304. doi: 10.1359/jbmr.2000.15.12.2297.
Grygorieva NV, Povoroznyuk VV, Zubach OB, Povoroznyuk VasV. Proximal Femoral Geometry and the Risk of Fractures: Literature Review. Bol', Sustavy, Pozvonochnik. 2016;(21):21-28. doi: 10.22141/2224-1507.1.21.2016.74088.
Alwis G, Karlsson C, Stenevi-Lundgren S, Rosengren BE, Karlsson MK. Femoral neck bone strength estimated by hip structural analysis (HSA) in Swedish Caucasians aged 6-90 years. Calcif Tissue Int. 2012 Mar;90(3):174-85. doi: 10.1007/s00223-011-9566-1.
Kaptoge S, Dalzell N, Loveridge N, Beck TJ, Khaw KT, Reeve J. Effects of gender, anthropometric variables, and aging on the evolution of hip strength in men and women aged over 65. Bone. 2003 May;32(5):561-70. PMID: 12753873.
Gong J, Tang M, Guo B, Shang J, Tang Y, Xu H. Sex- and age-related differences in femoral neck cross-sectional structural changes in mainland Chinese men and women measured using dual-energy X-ray absorptiometry. Bone. 2016 Feb;83:58-64. doi: 10.1016/j.bone.2015.09.017.
Zhang H, Hu YQ, Zhang ZL. Age trends for hip geometry in Chinese men and women and the association with femoral neck fracture. Osteoporos Int. 2011 Sep;22(9):2513-22. doi: 10.1007/s00198-010-1479-8.
Iki M, DongMei N, Tamaki J, et al. Age-specific reference values of hip geometric indices from a representative sample of the Japanese female population: Japanese Population-based Osteoporosis (JPOS) Study. Osteoporos Int. 2011 Jun;22(6):1987-96. doi: 10.1007/s00198-010-1406-z.
Copyright (c) 2019 N.V. Grygorieva, V.V. Povoroznyuk, Vas.V. Povoroznjuk, O.B. Zubach
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2019