Bone density and geometry in assessing hip fracture risk in post-menopausal women

Studies have shown that Raman spectroscopic analysis of fingernail clippings can help differentiate between post-menopausal women who have and who have not suffered a fracture. However, all studies to date have been retrospective in nature, comparing the proteins in nails sourced from women, post-fracture. The objective of this study was to investigate the potential of a prospective test for hip fracture based on spectroscopic analysis of nail tissue. Archived toenail samples from post-menopausal women aged 50 to 63 years in the Nurses’ Health Study were obtained and analysed by Raman spectroscopy. Nails were matched case-controls sourced from 161 women; 82 who underwent a hip fracture up to 20 years after nail collection and 81 age-matched controls. A number of clinical risk factors (CRFs) from the Fracture Risk Assessment (FRAX) tool had been assessed at toenail collection. Using 80% of the spectra, models were developed for increasing time periods between nail collection and fracture. Scores were calculated from these models for the other 20% of the sample and the ability of the score to predict hip fracture was tested in model with and without the CRFs by comparing the odds ratios (ORs) per 1 SD increase in standardised predictive values. The Raman score successfully distinguished between hip fracture cases and controls. With only the score as a predictor, a statistically significant OR of 2.2 (95% confidence interval [CI]: 1.5-3.1) was found for hip fracture for up to 20 years after collection. The OR increased to 3.8 (2.6-5.4) when the CRFs were added to the model. For fractures limited to 13 years after collection, the OR was 6.3 (3.0-13.1) for the score alone. The test based on Raman spectroscopy has potential for identifying individuals who may suffer hip fractures several years in advance. Higher powered studies are required to evaluate the predictive capability of this test.

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Fibrosis markers, hip fracture risk, and bone density in older adults

Osteoporosis International ◽

10.1007/s00198-015-3269-9 ◽

2015 ◽

Vol 27 (2) ◽

pp. 815-820 ◽

Cited By ~ 4

Author(s):

J. I. Barzilay ◽

P. Bůžková ◽

J. R. Kizer ◽

L. Djoussé ◽

J. H. Ix ◽

...

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Bone Density ◽

Fracture Risk ◽

Hip Fracture Risk

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Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

British Journal of Radiology ◽

10.1259/bjr.20130358 ◽

2014 ◽

Vol 87 (1037) ◽

pp. 20130358 ◽

Cited By ~ 12

Author(s):

C Ripamonti ◽

L Lisi ◽

M Avella

Keyword(s):

Hip Fracture ◽

Bone Density ◽

Femoral Neck ◽

Fracture Risk ◽

Neck Shaft Angle ◽

Hip Fracture Risk ◽

Shaft Angle ◽

Angle Width

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Multiple Regression Analysis of Hip Fracture Risk Assessment via Finite Element Analysis

Journal of Engineering and Science in Medical Diagnostics and Therapy ◽

10.1115/1.4049233 ◽

2020 ◽

Author(s):

Rabina Awal ◽

Tanvir Faisal

Keyword(s):

Regression Analysis ◽

Hip Fracture ◽

Bone Density ◽

Fracture Risk ◽

Multiple Regression Analysis ◽

Multiple Regression ◽

Mineral Density ◽

Hip Fracture Risk ◽

Loading Direction ◽

The Impact

Abstract An accurate assessment of hip fracture risk requires a proper consideration of parameters affecting the fracture. In general, hip fracture is assessed based on Bone Mineral Density (BMD) and load amount, but hip fracture is an outcome of the interaction of the parameters such as loading directions, bone density, which are often disregarded. Assessing the effect of the parameters individually may not correctly reflect the root cause of the hip fracture. Hence, this research aims at analyzing the significance of parameters and their interaction in assessing the fracture risk. A multiple regression analysis has been conducted considering bone density (\rho_ash), different loading directions during sideways fall, represented by load angle (\alpha) about femoral shaft on the coronal plane and angle (\beta) about femoral neck axis on the transverse plane as independent parameters and fracture risk index (FRI) as a dependent parameter. The statistical results showing the significant value of 0.7321 for , and 0.0001 for and ?_ash indicate that the effect of loading direction (\alpha) does not have impact on fracture risk in comparison with the loading direction (\beta) and (\rho_ash). Furthermore, the analysis of the interaction of parameters shows that the impact of \beta on fracture risk may depends more on bone density.

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