Details

Autor(en) / Beteiligte

• Cappelle, S.I.
• Moreau, M.
• Karmali, R.
• Iconaru, L.
• Baleanu, F.
• Kinnard, V.
• Paesmans, M.
• Rozenberg, S.
• Rubinstein, M.
• Surquin, M.
• Blard, P.-H.
• Chapurlat, R.
• Body, J.J.
• Bergmann, P.

Titel

Discriminating value of HR-pQCT for fractures in women with similar FRAX scores: A substudy of the FRISBEE cohort

Ist Teil von

• Bone (New York, N.Y.), 2021-02, Vol.143, p.115613-115613, Article 115613

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Areal bone mineral density (aBMD) has a low sensitivity to identify women at high fracture risk. The FRAX algorithm, by combining several clinical risk factors, might improve fracture prediction compared to aBMD alone. Several micro-architectural and biomechanical parameters which can be measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) are associated with fracture risk. HR-pQCT in combination or not with finite element analysis (FEA) may be used to improve bone strength prediction. Our aim was to assess whether HR-pQCT measurements (densities, cortical and trabecular microarchitecture, biomechanical proprieties assessed by FEA) had an added value in predicting fractures in a subgroup of women belonging to the Belgian FRISBEE cohort. One hundred nineteen women who sustained a fracture (aged 60 to 85 years) during the initial follow-up of our cohort had a radius and tibia examination by HR-pQCT and were compared with controls matched for their FRAX score at baseline. We found that low distal radius total (OR = 1.41 [1.07–1.86] per SD, p < 0.05) and trabecular densities (OR = 1.45 [1.10–1.90], p < 0.01), trabecular number (OR = 1.32 [1.01–1.72], p < 0.05), intra individual distribution of separation (OR = 0.73 [0.54–0.99], p < 0.05) as several FEA parameters were significantly associated with fractures. At the distal tibia, impaired cortical density (OR = 1.32 [1.03–1.70] per SD, p < 0.05) and thickness (OR = 1.29 [1.01–1.63], p < 0.05) and apparent modulus (OR = 1.30 [1.01–1.66], p < 0.05) were significantly correlated with fractures. A low ultra distal radial aBMD (UDR) measured at the time of HR-pQCT was significantly associated with fractures (OR = 1.67 [1.22–2.28], p < 0.01). Women from both groups were followed further after the realization of the HR-pQCT and 46 new fractures were registered. In this second part of the study, low UDR aBMD (OR = 1.66 [1.18–2.35], p < 0.01), total (OR = 1.48 [1.08–2.03], p < 0.05), cortical (OR = 1.40 [1.04–1.87], p < 0.05) and trabecular (OR = 1.37 [1.01–1.85], p < 0.05) densities or apparent modulus (OR = 1.49 [1.07–2.05], p < 0.05) at the radius were associated with a significant increase of fracture risk. At the tibia, only the cortical density was significantly associated with the fracture risk (OR = 1.34 [1.02–2.76], p < 0.05). These results confirm the interest of HR-pQCT measurements for the evaluation of fracture risk, also in women matched for their baseline FRAX score. They also highlight that UDR aBMD contains pertinent information. •417 women of the FRISBEE cohort, matched for FRAX, were evaluated by HR-pQCT.•Some HR-pQCT parameters, mainly at radius, are discriminating for prevalent fractures.•HR-pQCT improves the risk prediction beyond the DXA but not the FRAX score.•UDR aBMD also provides valuable information.