Analysis of Combined Indicators for Risk of Osteoporotic Hip Fracture in Elderly Women

Overview

Journal Orthop Surg

Specialty Orthopedics

Date 2021 May 4

PMID 33942553

Citations 3

Authors

Jin-Hui Zhao

Hui-Peng Shi

Da-Jun Jiang

Ling-Tian Wang

Sheng-Bao Chen

Wei-Tao Jia

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the accuracy of combined independent risk factors in assessing the risk of hip fractures in elderly women.

Methods: Ninety elderly females who sustained hip fractures (including femoral neck fractures and intertrochanteric fractures) and 110 female outpatients without a hip fracture were included in our cross-sectional study from 24 November 2017 to 20 May 2019. The age of subjects in the present study was ≥65 years, with the mean age of 78.73 ± 7.77 and 78.09 ± 5.03 years for women with and without elderly hip fractures, respectively. Bone mineral density (BMD), Beta-carboxy terminal telopeptide (β-CTX), N-terminal/mid region (N-MID), and 25(OH)D levels were analyzed. A novel evaluation model was established to evaluate combined indicators in assessing hip fractures in elderly women.

Results: Compared with the control group, taller height (155.68 ± 6.40 vs 150.97 ± 6.23, P < 0.01), higher levels of β-CTX (525.91 ± 307.38 vs 330.94 ± 289.71, P < 0.01), and lower levels of total hip BMD (0.662 ± 0.117 vs 0.699 ± 0.111, P = 0.022), femoral neck BMD (0.598 ± 0.106 vs 0.637 ± 0.100, P = 0.009), and 25(OH)D (15.67 ± 7.23 vs 29.53 ± 10.57, P < 0.01) were found in the facture group. After adjustment for confounding factors, logistic regression analysis revealed that 25(OH)D (adjusted OR 0.837 [95% CI 0.790-0.886]; P < 0.01), femoral neck BMD (adjusted OR 0.009 [95% CI 0.000-0.969]; P = 0.048) and height (adjusted OR 1.207 [95% CI 1.116-1.306]; P < 0.01) remained risk factors for hip fractures in elderly women. Then a model including independent risk factors was established. A DeLong test showed the area under the receiver operator characteristic (ROC) (Area under the curve [AUC]) of 25(OH)D was significantly greater than that for femoral neck BMD (P < 0.01) and height (P < 0.01). The AUC of model including 25(OH)D and height was significantly greater than that of other combinations (P < 0.01).

Conclusion: 25(OH)D, femoral neck BMD and height were associated with the occurrence of hip fractures in elderly women even after adjustment for confounding factors, and a model including 25(OH)D and height could provide better associated power than other combinations in the assessment of elderly hip fractures.

Citing Articles

Proportion and Risk Factors of Silent Vertebral Fractures Among Egyptian Females With Fragility Hip Fracture Presenting to the Emergency Room of Ain Shams University Hospitals.

Abdelrahman Ali M, Sweed H, Allam M, Aly W, Mohamed Matter A, Abdelalim Elshabrawy W Cureus. 2023; 15(9):e46214.

PMID: 37905273 PMC: 10613479. DOI: 10.7759/cureus.46214.

Risk factors of primary and recurrent fractures in postmenopausal osteoporotic Chinese patients: A retrospective analysis study.

Zhu X, Chen L, Pan L, Zeng Y, Fu Q, Liu Y BMC Womens Health. 2022; 22(1):465.

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The Impact of Coronal Configuration of the Proximal Femur on its Mechanical Properties and the Validation of a New Theoretical Model: Finite Element Analysis and Biomechanical Examination.

Zhang L, Zhu B, Chen L, Wang W, Zhang X, Zhang J Orthop Surg. 2022; 15(1):62-69.

PMID: 36250538 PMC: 9837247. DOI: 10.1111/os.13537.

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