What question did this study set out to answer?

To assess whether bone microarchitecture assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) improves fracture prediction in older men beyond areal bone mineral density (aBMD).

April 25, 2018Journal of Bone and Mineral Research

Prediction of Fractures in Men Using Bone Microarchitectural Parameters Assessed by High-Resolution Peripheral Quantitative Computed Tomography—The Prospective STRAMBO Study

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To assess whether bone microarchitecture assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) improves fracture prediction in older men beyond areal bone mineral density (aBMD).
Assessed distal radius and distal tibia microarchitecture and micro-finite element bone strength using HR-pQCT in 825 men aged 60 to 87 years at baseline.
Tracked incident vertebral and nonvertebral fractures across a prospective 8-year follow-up period.
Adjusted multivariable hazard models for age, BMI, prior falls, prior fractures, and standard aBMD.
Over the 8-year follow-up, 105 men sustained fractures, comprising 59 vertebral fractures in 49 men and 70 nonvertebral fractures in 68 men.
Low distal radius trabecular number was most strongly associated with higher fracture risk after aBMD adjustment (HR = 1.63 per SD, 95% CI 1.31–2.03, p < 0.001), as well as major osteoporotic fractures (HR = 1.80 per SD, p < 0.001) and vertebral fractures (HR = 1.78 per SD, p < 0.01).
Adding distal radius trabecular number increased estimated fracture probability in men with incident fractures by 4.1% (95% CI 1.9–6.3%, p < 0.001) versus those without, but did not significantly improve the area under the curve (AUC, p = 0.37).

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Implication

Prospective cohort study reveals bone microarchitecture independently associates with fracture risk in older men, suggesting limited clinical utility beyond standard density scans.

Cite This Study

Szulc et al. (2018) studied this question.

synapsesocial.com/papers/6a9b1c003d62f986e4f129ad https://doi.org/10.1002/jbmr.3451

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Implication

Prospective cohort study reveals bone microarchitecture independently associates with fracture risk in older men, suggesting limited clinical utility beyond standard density scans.

Prediction of Fractures in Men Using Bone Microarchitectural Parameters Assessed by High-Resolution Peripheral Quantitative Computed Tomography—The Prospective STRAMBO Study

Key Points

Discussion

Implication

Cite This Study

Prediction of Fractures in Men Using Bone Microarchitectural Parameters Assessed by High-Resolution Peripheral Quantitative Computed Tomography—The Prospective STRAMBO Study

Key Points

Discussion

Implication

Cite This Study

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