Osteoporosis & bone health

Trabecular bone mineral density as measured by thoracic vertebrae predicts incident hip and vertebral fractures: the multi-ethnic study of atherosclerosis

Osteoporos IntPublished Prospective cohort study

Main finding · First hip fractureResult — go to the resultHazard ratio 1.57 95% CI 1.38–1.95

Authors' conclusion

There is significant correlation between thoracic trabecular BMD and the incidence of future hip and vertebral fracture.

Study context

Population
Multi-Ethnic Study of Atherosclerosis (MESA) baseline participants from six medical centres across the USA (mean age 62.2 ± 10.2 years; 52.8% women)
Participants
6,814 participants
Exposure
Low vs normal thoracic trabecular bone mineral density (BMD) by QCT on non-contrast cardiac computed tomography (CT)
Outcome
Incident hip and vertebral fractures
Follow-up
Median 17.4 years
Methodological detailsmulticentre, multi-ethnic
  • Multicentre
  • Multi-ethnic

Main finding

First hip fracture

Hazard ratio

1.57

95% CI 1.38–1.95

Low BMDvs Normal BMD
HR 1.57 (95% CI 1.38–1.95)

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeHR (95% CI)
First vertebral fracture · median follow-up 17.4 years2.93 (1.87–4.59)
OutcomeDifference (mg/cm³)P value
Baseline vBMD, hip fracture vs no hip fractureLower in hip fracture patients13.6P < 0.001
Mean BMD, vertebral fracture vs no vertebral fractureLower in vertebral fracture population18.3P < 0.001

Mean thoracic BMD and osteoporosis prevalence at baseline

Mean thoracic BMD (mg/cm³)
162.6 ± 46.8 (95% CI 161.5, 163.7)
Osteoporosis (T-score 2.5 or lower)
27.6% (n = 1883)

Vertebral fracture rate by race · median follow-up 17.4 years

Caucasians
6.9%
Blacks
4.4%
Hispanics
3.7%
Chinese
3.0%

Original publication

Trabecular bone mineral density as measured by thoracic vertebrae predicts incident hip and vertebral fractures: the multi-ethnic study of atherosclerosis. Osteoporos Int. Published 22 March 2024. doi:10.1007/s00198-024-07040-5

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