机构：[1]Department of Radiology, Beijing Jishuitan Hospital, Beijing, China[2]Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, China医技片放射科云南省第一人民医院[3]Medical Research & Biometrics Center, National Center for Cardiovascular Disease, Beijing, China[4]Departments of Traumatic Orthopedics, Beijing Jishuitan Hospital, Beijing, China[5]Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China[6]School of Biomedical Engineering & Imaging Sciences, King’s College London, St Thomas’ Hospital, London, UK[7]Health Commission of Yunnan Province, Kunming, China[8]Department of Radiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China昆明医科大学附属第一医院[9]The First People’s Hospital of Yunnan Province, Kunming, China云南省第一人民医院[10]Center for Bone Quality, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands[11]Department of Medicine 3, FAU University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany[12]Institute of Medical Physics, University of Erlangen, Erlangen, Germany
Background Patients with a first hip fracture are at high risk of fracturing their other hip. Despite this, preventive therapy is often not given. Because little is known about specific risk factors of a second hip fracture, we investigated the association with areal bone mineral density (aBMD), muscle size, and density. We also investigated whether muscle parameters predict the risk of a contralateral fracture independently of aBMD. Methods Three groups were included, one without hip fracture (a subcohort of the China Action on Spine and Hip Status study), one with a first, and one with a second hip fracture. Subjects with fractures were recruited from the longitudinal Chinese Second Hip Fracture Evaluation (CSHFE). Computed tomography scans of CSHFE patients, which were obtained immediately following their first fracture, were used to measure cross-sectional area and density of the gluteus maximus (G.MaxM) and gluteus medius and minimus (G.Med/MinM) muscles. Computed tomography X-ray absorptiometry was used to measure aBMD of the contralateral femur. Median follow-up time to second fracture was 4.5 years. Cox proportional hazards models were used to compute hazard ratios (HR) of second hip fracture risk in subjects with a first hip fracture. Multivariate logistic regressions were used to compare odds ratios (OR) for the risk of a first and second hip fracture. Results Three hundred and one participants (68.4 +/- 6.1 years, 64% female) without and 302 participants (74.6 +/- 9.9 years, 71% female) with a first hip fracture were included in the analysis. Among the latter, 45 (79.2 +/- 7.1 years) sustained a second hip fracture. ORs for first hip fracture were significant for aBMD and muscle size and density. ORs for a second fracture were smaller by a factor of 3 to 4 and no longer significant for femoral neck (FN) aBMD. HRs for predicting second hip fracture confirmed the results. G.Med/MinM density (HR, 1.68; CI, 1.20-2.35) and intertrochanter aBMD (HR, 1.62; CI, 1.13-2.31) were the most significant. FN aBMD was not significant. G.Med/MinM density remained significant for predicting second hip fracture after adjustment for FN (HR, 1.66; Cl, 1.18-2.30) or total hip aBMD (HR, 1.50; 95% Cl, 1.04-2.15). Conclusions Density of the G.Med/MinM muscle is an aBMD independent predictor of the risk of second hip fracture. Intertrochanteric aBMD is a better predictor of second hip fracture than FN and total hip aBMD. These results may trigger a paradigm shift in the assessment of second hip fracture risk and prevention strategies.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81901718, 81771831]; Beijing Natural Science Foundation-Haidian Primitive Innovation Joint Fund [L172019]; Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support [ZYLX202107]
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外文
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PubmedID：
中科院(CAS)分区：
出版当年[2022]版：
大类|1 区医学
小类|1 区老年医学1 区医学：内科
最新[2023]版：
大类|1 区医学
小类|1 区老年医学1 区医学：内科
JCR分区：
出版当年[2021]版：
Q1GERIATRICS & GERONTOLOGYQ1MEDICINE, GENERAL & INTERNAL
最新[2023]版：
Q1MEDICINE, GENERAL & INTERNALQ1GERIATRICS & GERONTOLOGY
第一作者机构：[1]Department of Radiology, Beijing Jishuitan Hospital, Beijing, China[2]Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Radiology, Beijing Jishuitan Hospital, Beijing, China[2]Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, China[4]Departments of Traumatic Orthopedics, Beijing Jishuitan Hospital, Beijing, China[*1]Departments of Traumatic Orthopedics, Beijing Jishuitan Hospital, Beijing, China.[*2]Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China.[*3]Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, China.
推荐引用方式(GB/T 7714)：
Wang Ling,Yin Lu,Yang Minghui,et al.Muscle density is an independent risk factor of second hip fracture: a prospective cohort study[J].JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE.2022,13(3):1927-1937.doi:10.1002/jcsm.12996.
APA：
Wang, Ling,Yin, Lu,Yang, Minghui,Ge, Yufeng,Liu, Yandong...&Engelke, Klaus.(2022).Muscle density is an independent risk factor of second hip fracture: a prospective cohort study.JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE,13,(3)
MLA：
Wang, Ling,et al."Muscle density is an independent risk factor of second hip fracture: a prospective cohort study".JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE 13..3(2022):1927-1937
医学