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dc.contributor.authorAhmed, Luai Awad
dc.contributor.authorShigdel, Rajesh
dc.contributor.authorJoakimsen, Ragnar Martin
dc.contributor.authorEldevik, Odd Petter
dc.contributor.authorEriksen, Erik Fink
dc.contributor.authorGhasem-Zadeh, Ali
dc.contributor.authorBala, Yohann
dc.contributor.authorZebaze, Roger
dc.contributor.authorSeeman, Ego
dc.contributor.authorBjørnerem, Åshild
dc.date.accessioned2016-03-17T13:06:14Z
dc.date.available2016-03-17T13:06:14Z
dc.date.issued2015-04-16
dc.description.abstractSummary We tested whether cortical porosity of the proximal femur measured using StrAx1.0 software provides additional information to areal bone mineral density (aBMD) or Fracture Risk Assessment Tool (FRAX) in differentiating women with and without fracture. Porosity was associated with fracture independent of aBMD and FRAX and identified additional women with fractures than by osteoporosis or FRAX thresholds. Introduction Neither aBMD nor the FRAX captures cortical porosity, a major determinant of bone strength. We therefore tested whether combining porosity with aBMD or FRAX improves identification of women with fractures. Methods We quantified femoral neck (FN) aBMD using dual-energy X-ray absorptiometry, FRAX score, and femoral subtrochanteric cortical porosity using StrAx1.0 software in 211 postmenopausal women aged 54–94 years with nonvertebral fractures and 232 controls in Tromsø, Norway. Odds ratios (ORs) were calculated using logistic regression analysis. Results Women with fractures had lower FN aBMD, higher FRAX score, and higher cortical porosity than controls (all p < 0.001). Each standard deviation higher porosity was associated with fracture independent of FN aBMD (OR 1.39; 95 % confidence interval 1.11–1.74) and FRAX score (OR 1.58; 1.27–1.97) in all women combined. Porosity was also associated with fracture independent of FRAX score in subgroups with normal FN aBMD (OR 1.88; 1.21–2.94), osteopenia (OR 1.40; 1.06–1.85), but not significantly in those with osteoporosis (OR 1.48; 0.68–3.23). Of the 211 fracture cases, only 18 women (9 %) were identified using FN aBMD T-score < −2.5, 45 women (21 %) using FRAX threshold >20 %, whereas porosity >80th percentile identified 61 women (29 %). Porosity identified 26 % additional women with fractures than identified by the osteoporosis threshold and 21 % additional women with fractures than by this FRAX threshold. Conclusions Cortical porosity is a risk factor for fracture independent of aBMD and FRAX and improves identification of women with fracture.en_US
dc.descriptionPublished version. Source at <a href=http://doi.org/10.1007/s00198-015-3118-x>http://doi.org/10.1007/s00198-015-3118-x</a>.en_US
dc.identifier.citationOsteoporosis International 2015, 26(8):2137-2146en_US
dc.identifier.cristinIDFRIDAID 1252546
dc.identifier.doi10.1007/s00198-015-3118-x
dc.identifier.issn0937-941X
dc.identifier.urihttps://hdl.handle.net/10037/9023
dc.identifier.urnURN:NBN:no-uit_munin_8590
dc.language.isoengen_US
dc.publisherSpringeren_US
dc.rights.accessRightsopenAccess
dc.subjectBone mineral densityen_US
dc.subjectCortical porosityen_US
dc.subjectFRAXen_US
dc.subjectNonvertebral fracturesen_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleMeasurement of cortical porosity of the proximal femur improves identification of women with nonvertebral fragility fracturesen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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