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Risk prediction of second hip fracture by bone and muscle density of the hip varies with time after first hip fracture: A prospective cohort study

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机构: [1]Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China [2]Departments of Traumatic Orthopedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China [3]Department of Radiology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China [4]Information Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing 100037, China [5]School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London, United Kingdom [6]Department of Radiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China [7]Department of Orthopaedic Surgery and Traumatology, Turku University Hospital and University of Turku, Turku, Finland [8]Center for Bone Quality, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands [9]Department of Medicine 3, FAU University Erlangen-Nürnberg, Universit¨atsklinikum Erlangen, Erlangen, Germany [10]Institute of Medical Physics, University of Erlangen, Erlangen, Germany
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关键词: Second hip fracture Bone mineral density Muscle density Risk predictor

摘要:
Purpose: Predictors of 'imminent' risk of second hip fracture are unknown. The aims of the study were to explore strength of hip areal bone mineral density (aBMD), and muscle area and density for predicting second hip fracture at different time intervals.Methods: Data of the Chinese Second Hip Fracture Evaluation were analyzed, a longitudinal study to evaluate the risk of second hip fracture (of the contralateral hip) by using CT images obtained immediately after first hip fracture. Muscle cross-sectional area and density were measured of the gluteus maximus (G.MaxM) and gluteus medius and minimus (G.Med/MinM) and aBMD of the proximal femur at the contralateral unfractured side. Patients were followed up for a median time of 4.5 years. Separate Cox models were used to predict second hip fracture risk at different time intervals after first event adjusted for age, sex, BMI and diabetes. Results: The mean age of subjects with imminent (within 1st or 2nd year) second hip fracture was 79.80 +/- 5.16 and 81.56 +/- 3.64 years. In the 1st year after the first hip fracture, femoral neck (FN) aBMD predicted second hip fracture (HR 5.88; 95 % CI, 1.32-26.09). In the remaining years of follow-up after 2nd year, muscle density predicted second hip fracture (G.MaxM HR 2.13; 95 % CI, 1.25-3.65,G.Med/MinM HR 2.10; 95 % CI, 1.32-3.34).Conclusions: Our results show that femoral neck aBMD is an important predictor for second hip fracture within the first year and therefore suggest supports the importance concept of early and rapid-acting bone-active drugs to increase hip BMD. In addition, the importance of muscle density predicting second hip fracture after the second year suggest post hip fracture rehabilitation and exercise programs could also be important to reduce muscle fatty infiltration.

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出版当年[2023]版:
Q3 ENDOCRINOLOGY & METABOLISM
最新[2023]版:
Q3 ENDOCRINOLOGY & METABOLISM

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

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第一作者机构: [1]Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
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通讯机构: [1]Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China [4]Information Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing 100037, China [*1]Information Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Fuwai Hospital, Beijing 100037, China. [*2]Department of Radiology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China.
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