Association of moderate/severe vertebral fractures with reduced trabecular volumetric bone density in older women and reduced areal femoral neck bone density in older men from the community: A cross-sectional study (SPAH)

• Published in: Maturitas Vol. 120; pp. 61 - 67
• Main Authors: Torres, Georgea H.F., Guzman, Luis F.E., Alvarenga, Jackeline C., Lopes, Neuza H.M., Pereira, Rosa M.R.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.02.2019
• Subjects: Absorptiometry, Photon; Aged; Aged, 80 and over; Bone Density; Bone microarchitecture; Cancellous Bone - diagnostic imaging; Cross-Sectional Studies; DXA; Female; Femur Neck - diagnostic imaging; HR-pQCT; Humans; Independent Living; Male; Radius - diagnostic imaging; Risk Assessment; Spinal Fractures - diagnostic imaging; TBS; Tibia - diagnostic imaging; Tomography, X-Ray Computed - methods; Vertebral fractures; VFA; VF; Vertebral fractures; OR; TBS; Bone microarchitecture; HR-pQCT; DXA; SP
• DOI: 10.1016/j.maturitas.2018.11.019
• ISSN: 0378-5122

•Vertebral fractures (VF) are a hallmark of osteoporosis and important cause of morbidity and mortality.•Moderate/severe VF fractures were associated with trabecular volumetric bone density using HR-pQCT at tibia in older women.•Moderate/severe VF were associated with femoral neck areal bone mineral density in older men from community. Many vertebral fractures (VF) occur in individuals classified by DXA as being at low risk of fragility fractures. The aim of this study was to verify the association between VF and peripheral bone microarchitecture and strength parameters (SP) using, in addition to DXA, high-resolution peripheral quantitative computed tomography (HR-pQCT) and axial bone microarchitecture using the trabecular bone score (TBS). Cross-sectional study of 276 community-dwelling subjects aged ≥65 years from the SPAH study cohort. Lateral DXA scans of the spine were analyzed to assess VF. HR-pQCT was performed at the radius and tibia. TBS was determined using DXA. VF was observed in 42.6% of women and 28% of men. At the tibia, women with moderate/severe VF had lower volumetric bone density (vBMD), trabecular number (Tb.N), and SP, and higher trabecular separation (Tb.Sp); and men with VF had lower Tb.N and SP, and higher Tb.Sp. At the radius, women with moderate/severe VF had lower vBMD, trabecular and cortical thickness and SP; and men with VF had lower trabecular vBMD and SP. No associations between TBS and VF were observed in either gender. Logistic regression analysis revealed that trabecular vBMD at the tibia in women (OR:0.980, 95%CI:0.963–0.997, p = 0.022) and femoral neck aBMD in men (OR:0.445, 95%CI:0.212–0.935, p = 0.033) were independently associated with VF. HR-pQCT images detected differences in bone microstructure in older women with VF independent of aBMD and TBS by DXA, and HR-pQCT could be a useful tool to assess fracture risk. In men, femoral neck aBMD was associated with VF, and DXA continues to be an important tool for predicting VF.