Prediction of clinical non-spine fractures in older black and white men and women with volumetric BMD of the spine and areal BMD of the hip: The health, aging, and body composition study

Dawn C. Mackey, Jean Gaare Eby, Fran Harris, Dennis R. Taaffe, Jane A. Cauley, Frances Tylavsky, Tamara B. Harris, Thomas F. Lang, Steven R. Cummings

Research output: Contribution to journalArticle

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Abstract

In a prospective study of 1446 black and white adults 70-79 yr of age (average follow-up, 6.4 yr), vertebral TrvBMD from QCT predicted non-spine fracture in black and white women and black men, but it was not a stronger predictor than total hip aBMD from DXA. Hip aBMD predicted non-spine fracture in black men. Introduction: Areal BMD (aBMD) at multiple skeletal sites predicts clinical non-spine fractures in white and black women and white men. The predictive ability of vertebral trabecular volumetric BMD (TrvBMD) for all types of clinical non-spine fractures has never been tested or compared with hip aBMD. Also, the predictive accuracy of hip aBMD has never been tested prospectively for black men. Materials and Methods: We measured vertebral TrvBMD with QCT and hip aBMD with DXA in 1446 elderly black and white adults (70-79 yr) in the Health, Aging, and Body Composition Study. One hundred fifty-two clinical non-spine fractures were confirmed during an average of 6.4 yr of >95% complete follow-up. We used Cox proportional hazards regression to determine the hazard ratio (HR) and 95% CIs of non-spine fracture per SD reduction in hip aBMD and vertebral TrvBMD. Results: Vertebral TrvBMD and hip aBMD were both associated with risk of non-spine fracture in black and white women and black men. The age-adjusted HR of fracture per SD decrease in BMD was highest in black men (hip aBMD: HR = 2.04, 95% CT = 1.03, 4.04; vertebral TrvBMD: HR = 3.00, 95% CT = 1.29, 7.00) and lowest in white men (hip aBMD: HR = 1.23, 95% CT = 0.85. 1.78; vertebral TrvBMD: HR = 1.06, 95% CI = 0.73, 1.54). Adjusted for age, sex, and race, each SD decrease in hip aBMD was associated with a 1.67-fold (95% CI = 1.36, 2.07) greater risk of fracture, and each SD decrease in vertebral TrvBMD was associated with a 1.47-fold (95% CI = 1.18, 1.82) greater risk. Combining measurements of hip aBMD and vertebral TrvBMD did not improve fracture prediction. Conclusions: Low BMD measured by either spine QCT or hip DXA predicts non-spine fracture in older black and white women and black men. Vertebral TrvBMD is not a stronger predictor than hip aBMD of non-spine fracture.

Original languageEnglish (US)
Pages (from-to)1862-1868
Number of pages7
JournalJournal of Bone and Mineral Research
Volume22
Issue number12
DOIs
StatePublished - Dec 1 2007

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Body Composition
Hip
Spine
Health
hydroquinone
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery

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Prediction of clinical non-spine fractures in older black and white men and women with volumetric BMD of the spine and areal BMD of the hip : The health, aging, and body composition study. / Mackey, Dawn C.; Eby, Jean Gaare; Harris, Fran; Taaffe, Dennis R.; Cauley, Jane A.; Tylavsky, Frances; Harris, Tamara B.; Lang, Thomas F.; Cummings, Steven R.

In: Journal of Bone and Mineral Research, Vol. 22, No. 12, 01.12.2007, p. 1862-1868.

Research output: Contribution to journalArticle

Mackey, Dawn C. ; Eby, Jean Gaare ; Harris, Fran ; Taaffe, Dennis R. ; Cauley, Jane A. ; Tylavsky, Frances ; Harris, Tamara B. ; Lang, Thomas F. ; Cummings, Steven R. / Prediction of clinical non-spine fractures in older black and white men and women with volumetric BMD of the spine and areal BMD of the hip : The health, aging, and body composition study. In: Journal of Bone and Mineral Research. 2007 ; Vol. 22, No. 12. pp. 1862-1868.
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title = "Prediction of clinical non-spine fractures in older black and white men and women with volumetric BMD of the spine and areal BMD of the hip: The health, aging, and body composition study",
abstract = "In a prospective study of 1446 black and white adults 70-79 yr of age (average follow-up, 6.4 yr), vertebral TrvBMD from QCT predicted non-spine fracture in black and white women and black men, but it was not a stronger predictor than total hip aBMD from DXA. Hip aBMD predicted non-spine fracture in black men. Introduction: Areal BMD (aBMD) at multiple skeletal sites predicts clinical non-spine fractures in white and black women and white men. The predictive ability of vertebral trabecular volumetric BMD (TrvBMD) for all types of clinical non-spine fractures has never been tested or compared with hip aBMD. Also, the predictive accuracy of hip aBMD has never been tested prospectively for black men. Materials and Methods: We measured vertebral TrvBMD with QCT and hip aBMD with DXA in 1446 elderly black and white adults (70-79 yr) in the Health, Aging, and Body Composition Study. One hundred fifty-two clinical non-spine fractures were confirmed during an average of 6.4 yr of >95{\%} complete follow-up. We used Cox proportional hazards regression to determine the hazard ratio (HR) and 95{\%} CIs of non-spine fracture per SD reduction in hip aBMD and vertebral TrvBMD. Results: Vertebral TrvBMD and hip aBMD were both associated with risk of non-spine fracture in black and white women and black men. The age-adjusted HR of fracture per SD decrease in BMD was highest in black men (hip aBMD: HR = 2.04, 95{\%} CT = 1.03, 4.04; vertebral TrvBMD: HR = 3.00, 95{\%} CT = 1.29, 7.00) and lowest in white men (hip aBMD: HR = 1.23, 95{\%} CT = 0.85. 1.78; vertebral TrvBMD: HR = 1.06, 95{\%} CI = 0.73, 1.54). Adjusted for age, sex, and race, each SD decrease in hip aBMD was associated with a 1.67-fold (95{\%} CI = 1.36, 2.07) greater risk of fracture, and each SD decrease in vertebral TrvBMD was associated with a 1.47-fold (95{\%} CI = 1.18, 1.82) greater risk. Combining measurements of hip aBMD and vertebral TrvBMD did not improve fracture prediction. Conclusions: Low BMD measured by either spine QCT or hip DXA predicts non-spine fracture in older black and white women and black men. Vertebral TrvBMD is not a stronger predictor than hip aBMD of non-spine fracture.",
author = "Mackey, {Dawn C.} and Eby, {Jean Gaare} and Fran Harris and Taaffe, {Dennis R.} and Cauley, {Jane A.} and Frances Tylavsky and Harris, {Tamara B.} and Lang, {Thomas F.} and Cummings, {Steven R.}",
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TY - JOUR

T1 - Prediction of clinical non-spine fractures in older black and white men and women with volumetric BMD of the spine and areal BMD of the hip

T2 - The health, aging, and body composition study

AU - Mackey, Dawn C.

AU - Eby, Jean Gaare

AU - Harris, Fran

AU - Taaffe, Dennis R.

AU - Cauley, Jane A.

AU - Tylavsky, Frances

AU - Harris, Tamara B.

AU - Lang, Thomas F.

AU - Cummings, Steven R.

PY - 2007/12/1

Y1 - 2007/12/1

N2 - In a prospective study of 1446 black and white adults 70-79 yr of age (average follow-up, 6.4 yr), vertebral TrvBMD from QCT predicted non-spine fracture in black and white women and black men, but it was not a stronger predictor than total hip aBMD from DXA. Hip aBMD predicted non-spine fracture in black men. Introduction: Areal BMD (aBMD) at multiple skeletal sites predicts clinical non-spine fractures in white and black women and white men. The predictive ability of vertebral trabecular volumetric BMD (TrvBMD) for all types of clinical non-spine fractures has never been tested or compared with hip aBMD. Also, the predictive accuracy of hip aBMD has never been tested prospectively for black men. Materials and Methods: We measured vertebral TrvBMD with QCT and hip aBMD with DXA in 1446 elderly black and white adults (70-79 yr) in the Health, Aging, and Body Composition Study. One hundred fifty-two clinical non-spine fractures were confirmed during an average of 6.4 yr of >95% complete follow-up. We used Cox proportional hazards regression to determine the hazard ratio (HR) and 95% CIs of non-spine fracture per SD reduction in hip aBMD and vertebral TrvBMD. Results: Vertebral TrvBMD and hip aBMD were both associated with risk of non-spine fracture in black and white women and black men. The age-adjusted HR of fracture per SD decrease in BMD was highest in black men (hip aBMD: HR = 2.04, 95% CT = 1.03, 4.04; vertebral TrvBMD: HR = 3.00, 95% CT = 1.29, 7.00) and lowest in white men (hip aBMD: HR = 1.23, 95% CT = 0.85. 1.78; vertebral TrvBMD: HR = 1.06, 95% CI = 0.73, 1.54). Adjusted for age, sex, and race, each SD decrease in hip aBMD was associated with a 1.67-fold (95% CI = 1.36, 2.07) greater risk of fracture, and each SD decrease in vertebral TrvBMD was associated with a 1.47-fold (95% CI = 1.18, 1.82) greater risk. Combining measurements of hip aBMD and vertebral TrvBMD did not improve fracture prediction. Conclusions: Low BMD measured by either spine QCT or hip DXA predicts non-spine fracture in older black and white women and black men. Vertebral TrvBMD is not a stronger predictor than hip aBMD of non-spine fracture.

AB - In a prospective study of 1446 black and white adults 70-79 yr of age (average follow-up, 6.4 yr), vertebral TrvBMD from QCT predicted non-spine fracture in black and white women and black men, but it was not a stronger predictor than total hip aBMD from DXA. Hip aBMD predicted non-spine fracture in black men. Introduction: Areal BMD (aBMD) at multiple skeletal sites predicts clinical non-spine fractures in white and black women and white men. The predictive ability of vertebral trabecular volumetric BMD (TrvBMD) for all types of clinical non-spine fractures has never been tested or compared with hip aBMD. Also, the predictive accuracy of hip aBMD has never been tested prospectively for black men. Materials and Methods: We measured vertebral TrvBMD with QCT and hip aBMD with DXA in 1446 elderly black and white adults (70-79 yr) in the Health, Aging, and Body Composition Study. One hundred fifty-two clinical non-spine fractures were confirmed during an average of 6.4 yr of >95% complete follow-up. We used Cox proportional hazards regression to determine the hazard ratio (HR) and 95% CIs of non-spine fracture per SD reduction in hip aBMD and vertebral TrvBMD. Results: Vertebral TrvBMD and hip aBMD were both associated with risk of non-spine fracture in black and white women and black men. The age-adjusted HR of fracture per SD decrease in BMD was highest in black men (hip aBMD: HR = 2.04, 95% CT = 1.03, 4.04; vertebral TrvBMD: HR = 3.00, 95% CT = 1.29, 7.00) and lowest in white men (hip aBMD: HR = 1.23, 95% CT = 0.85. 1.78; vertebral TrvBMD: HR = 1.06, 95% CI = 0.73, 1.54). Adjusted for age, sex, and race, each SD decrease in hip aBMD was associated with a 1.67-fold (95% CI = 1.36, 2.07) greater risk of fracture, and each SD decrease in vertebral TrvBMD was associated with a 1.47-fold (95% CI = 1.18, 1.82) greater risk. Combining measurements of hip aBMD and vertebral TrvBMD did not improve fracture prediction. Conclusions: Low BMD measured by either spine QCT or hip DXA predicts non-spine fracture in older black and white women and black men. Vertebral TrvBMD is not a stronger predictor than hip aBMD of non-spine fracture.

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