Long-term fracture prediction by bone mineral assessed at different skeletal sites

TLDR

The study measured lumbar spine, cervical, intertrochanteric, distal and midradius bone mineral density and content using dual‑ and single‑photon absorptiometry in 304 women aged 30–94. Over a median 8.3‑year follow‑up, 93 women sustained 163 fractures, and each 1‑SD decrease in lumbar spine or femoral BMD increased vertebral or hip fracture risk equivalently to a 17‑ or 13‑14‑year age rise, demonstrating that multi‑site bone mineral assessments predict moderate‑trauma fractures for 8–10 years.

Abstract

Abstract Bone mineral density (BMD) was measured at the lumbar spine and cervical and intertrochanteric regions of the proximal femur by dual-photon absorptiometry and bone mineral content was assessed at the distal and midradius by single-photon absorptiometry in an age-stratified random sample of 304 Rochester, Minnesota women aged 30–94 years. Over follow-up extending to 10 years (median 8.3 years), 93 women experienced 163 new fractures. After adjusting for age, these bone mineral measurements predicted the likelihood of any incident fracture due to moderate trauma, with relative hazards varying from 1.4 to 1.6 per SD decrease in baseline bone mineral. A 1 SD decrease in lumbar spine BMD increased the risk of a new vertebral fracture comparably to a 17 year increase in age; a 1 SD decrease in femoral BMD was comparable to a 13–14 year increase in age on the risk of a hip fracture. We conclude that bone mineral measurements made at a variety of skeletal sites can predict the occurrence for at least 8–10 years of moderate trauma fractures of the sort that might be related to osteoporosis.