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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00006531naa a2200649 4500
001oai:gup.ub.gu.se/274872
003SwePub
008240528s2019 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/2748722 URI
0247 a https://doi.org/10.1016/S2213-8587(18)30308-52 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Samelson, Elizabeth J4 aut
2451 0a Cortical and trabecular bone microarchitecture as an independent predictor of incident fracture risk in older women and men in the Bone Microarchitecture International Consortium (BoMIC): a prospective study.
264 1c 2019
520 a Although areal bone mineral density (aBMD) assessed by dual-energy x-ray absorptiometry (DXA) is the clinical standard for determining fracture risk, most older adults who sustain a fracture have T scores greater than -2·5 and thus do not meet the clinical criteria for osteoporosis. Importantly, bone fragility is due to low BMD and deterioration in bone structure. We assessed whether indices of high-resolution peripheral quantitative CT (HR-pQCT) were associated with fracture risk independently of femoral neck aBMD and the Fracture Risk Assessment Tool (FRAX) score.We assessed participants in eight cohorts from the USA (Framingham, Mayo Clinic), France (QUALYOR, STRAMBO, OFELY), Switzerland (GERICO), Canada (CaMos), and Sweden (MrOS). We used Cox proportional hazard ratios (HRs) to estimate the association between HR-pQCT bone indices (per 1 SD of deficit) and incident fracture, adjusting for age, sex, height, weight, and cohort, and then additionally for femoral neck DXA aBMD or FRAX.7254 individuals (66% women and 34% men) were assessed. Mean baseline age was 69 years (SD 9, range 40-96). Over a mean follow-up of 4·63 years (SD 2·41) years, 765 (11%) participants had incident fractures, of whom 633 (86%) had femoral neck T scores greater than -2·5. After adjustment for age, sex, cohort, height, and weight, peripheral skeleton failure load had the greatest association with risk of fracture: tibia HR 2·40 (95% CI 1·98-2·91) and radius 2·13 (1·77-2·56) per 1 SD decrease. HRs for other bone indices ranged from 1·12 (95% CI 1·03-1·23) per 1 SD increase in tibia cortical porosity to 1·58 (1·45-1·72) per 1 SD decrease in radius trabecular volumetric bone density. After further adjustment for femoral neck aBMD or FRAX score, the associations were reduced but remained significant for most bone parameters. A model including cortical volumetric bone density, trabecular number, and trabecular thickness at the distal radius and a model including these indices plus cortical area at the tibia were the best predictors of fracture.HR-pQCT indices and failure load improved prediction of fracture beyond femoral neck aBMD or FRAX scores alone. Our findings from a large international cohort of men and women support previous reports that deficits in trabecular and cortical bone density and structure independently contribute to fracture risk. These measurements and morphological assessment of the peripheral skeleton might improve identification of people at the highest risk of fracture.National Institutes of Health National Institute of Arthritis Musculoskeletal and Skin Diseases.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Endokrinologi och diabetes0 (SwePub)302052 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Endocrinology and Diabetes0 (SwePub)302052 hsv//eng
7001 a Broe, Kerry E4 aut
7001 a Xu, Hanfei4 aut
7001 a Yang, Laiji4 aut
7001 a Boyd, Steven4 aut
7001 a Biver, Emmanuel4 aut
7001 a Szulc, Pawel4 aut
7001 a Adachi, Jonathan4 aut
7001 a Amin, Shreyasee4 aut
7001 a Atkinson, Elizabeth4 aut
7001 a Berger, Claudie4 aut
7001 a Burt, Lauren4 aut
7001 a Chapurlat, Roland4 aut
7001 a Chevalley, Thierry4 aut
7001 a Ferrari, Serge4 aut
7001 a Goltzman, David4 aut
7001 a Hanley, David A4 aut
7001 a Hannan, Marian T4 aut
7001 a Khosla, Sundeep4 aut
7001 a Liu, Ching-Ti4 aut
7001 a Lorentzon, Mattias,d 1970u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Centre for Bone and Arthritis Research,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition4 aut0 (Swepub:gu)xlomat
7001 a Mellström, Dan,d 1945u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Centre for Bone and Arthritis Research,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition4 aut0 (Swepub:gu)xmelda
7001 a Merle, Blandine4 aut
7001 a Nethander, Maria,d 1980u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Core Facilities, Bioinformatics,Centre for Bone and Arthritis Research,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Core Facilities, Bioinformatics4 aut0 (Swepub:gu)xnetma
7001 a Rizzoli, René4 aut
7001 a Sornay-Rendu, Elisabeth4 aut
7001 a Van Rietbergen, Bert4 aut
7001 a Sundh, Daniel,d 1985u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Centre for Bone and Arthritis Research,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition4 aut0 (Swepub:gu)xsundd
7001 a Wong, Andy Kin On4 aut
7001 a Ohlsson, Claes,d 1965u Gothenburg University,Göteborgs universitet,Centre for Bone and Arthritis Research,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition4 aut0 (Swepub:gu)xohlcl
7001 a Demissie, Serkalem4 aut
7001 a Kiel, Douglas P4 aut
7001 a Bouxsein, Mary L4 aut
7102 a Göteborgs universitetb Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition4 org
7730 t The lancet. Diabetes & endocrinologyg 7:1, s. 34-43q 7:1<34-43x 2213-8595
8564 8u https://gup.ub.gu.se/publication/274872
8564 8u https://doi.org/10.1016/S2213-8587(18)30308-5

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