| 1. |
- Karlsson, M. K., et al.
(författare)
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Bone mineral mass in hip fracture patients
- 1993
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Ingår i: Bone. - : Elsevier BV. - 8756-3282. ; 14:2, s. 161-165
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to measure the bone mineral density (BMD) and some anthropometric variables in patients with hip fracture, to compare these data with those from controls, and to compare the fractured and unfractured hip. Bone mineral measurements with dual energy X-ray absorptiometry (DEXA) were undertaken in 93 consecutive hip fracture patients, 26 men and 67 women, with a mean age of 75 and 78 years, respectively, within 10 days after injury. We found lower BMD in most measurements in both men and women compared with age- and sex-matched controls. The body weight and lean body mass were also significantly lower in the male hip fracture patients; in women only weight was lower. In women there was lower BMD in spine and hip in those who had sustained trochanteric hip fractures compared with those with cervical fracture. No such difference was found in men. There was no difference in BMD in the hip when patients with stable and unstable fractures were compared. In the fractured and nonfractured hips we measured BMD in regions of interest. In women with trochanteric hip fractures the BMD was decreased in the fractured hip compared with the uninjured. No such difference was found for cervical fractures or in men.
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| 2. |
- Kanis, J.A., et al.
(författare)
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Prediction of fracture from low bone mineral density measurements overestimates risk
- 2000
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Ingår i: Bone (New York, N.Y.). - : Elsevier Inc. - 1873-2763 .- 8756-3282. ; 26:4, s. 387-391
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Tidskriftsartikel (refereegranskat)abstract
- There is a well-established relationship between bone mineral density (BMD) and fracture risk. Estimates of the relative risk of fracture from BMD have been derived mainly from short-term studies in which the correlation between BMD at assessment and BMD in later life ranged from 0.8 to 0.9. Because individuals lose bone mineral at different rates throughout later life, the long-term predictive value of low BMD is likely to decrease progressively with time. This article examines and formalizes the relationship between current BMD, correlation coefficients, and long-term risk. The loss of predictive value has important implications for early assessment and supports the view that measurements should be optimally targeted at the time interventions are contemplated and, when necessary, repeated in later life.
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| 3. |
- Kanis, J.A, et al.
(författare)
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Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis
- 2000
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Ingår i: Bone. - : Elsevier Inc. - 1873-2763 .- 8756-3282. ; 27:5, s. 585-590
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Tidskriftsartikel (refereegranskat)abstract
- The risk of hip fracture is commonly expressed as a relative risk. The aim of this study was to examine the utility of relative risks of hip fracture in men and women using World Health Organization (WHO) diagnostic criteria for low bone mass and osteoporosis. Reference data for bone mineral density (BMD) at the femoral neck, from the third National Health and Nutrition Examination Survey (NHANES III), were applied to the population of Sweden. Relative risks (RRs) were calculated from the known relationship between BMD at the femoral neck and hip fracture risk. The apparent prevalence of low bone mass and osteoporosis depended on the segment of the young population chosen for reference ranges. Using a reference derived from women aged 20–29 years, the prevalence of osteoporosis was 21.2% in women between the ages of 50 and 84 years and 6.3% in men. The RRs associated with osteoporosis depended markedly on the risk comparison. For example, in men or women aged 50 years, the RR of hip fracture in those with osteoporosis compared to those without osteoporosis was 7.4 and 6.1, respectively. The RR of those at the threshold value for osteoporosis compared to those with an average value for BMD at that age was 6.6 and 4.6 in men and women, respectively. RRs were lower comparing those at the threshold value compared to the risk of the general population at that age (4.2 and 2.9, respectively). When RR was expressed in relation to the population risk rather than to the risk at the average value for BMD, RR decreased at all ages by 37%. Such adjustments are required for risk assessment in individuals and for the combined use of different risk factors. Because the average T score at each age decreased with age, the RR of hip fracture at any age decreased with advancing age in the presence of osteoporosis. The decrease in relative risk with age is, however, associated with an increase in absolute risk. Thus, for clinical use, the expression of absolute risks may be preferred to relative risks.
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