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Axial and appendicular bone density predict fractures in older womenTo determine whether measurement of hip and spine bone mass by dual-energy x-ray absorptiometry (DEXA) predicts fractures in women and to compare the predictive value of DEXA with that of single-photon absorptiometry (SPA) of appendicular sites, we prospectively studied 8134 nonblack women age 65 years and older who had both DEXA and SPA measurements of bone mass. A total of 208 nonspine fractures, including 37 wrist fractures, occurred during the follow-up period, which averaged 0.7 years. The risk of fracture was inversely related to bone density at all measurement sites. After adjusting for age, the relative risks per decrease of 1 standard deviation in bone density for the occurrence of any fracture was 1.40 for measurement at the proximal femur (95% confidence interval 1.20-1.63) and 1.35 (1.15-1.58) for measurement at the spine. Results were similar for all regions of the proximal femur as well as SPA measurements at the calcaneus, distal radius, and proximal radius. None of these measurements was a significantly better predictor of fractures than the others. Furthermore, measurement of the distal radius was not a better predictor of wrist fracture (relative risk 1.64: 95% CI 1.13-2.37) than other sites, such as the lumbar spine (RR 1.56; CI 1.07-2.26), the femoral neck (RR 1.65; CI 1.12-2.41), or the calcaneus (RR 1.83; CI 1.26-2.64). We conclude that the inverse relationship between bone mass and risk of fracture in older women is similar for absorptiometric measurements made at the hip, spine, and appendicular sites.
Document ID
20050000673
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Black, D. M.
(University of California San Francisco)
Cummings, S. R.
Genant, H. K.
Nevitt, M. C.
Palermo, L.
Browner, W.
Date Acquired
August 22, 2013
Publication Date
June 1, 1992
Publication Information
Publication: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
Volume: 7
Issue: 6
ISSN: 0884-0431
Subject Category
Aerospace Medicine
Funding Number(s)
CONTRACT_GRANT: 5-RO1-AG05394
CONTRACT_GRANT: 1-RO1-AR35582
CONTRACT_GRANT: 1-RO1-AG-05407
Distribution Limits
Public
Copyright
Other
Keywords
Multicenter Study
Clinical Trial
Non-NASA Center
NASA Discipline Musculoskeletal

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