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

Wang L, Yang M, Ge Y, Liu Y, Wang G, Su Y, Guo Z, Yin L, Huang P, Geng J, Blake GM, He B, Zhu S, Cheng X, Wu X, Aro HT, Vlug A, Engelke K (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Bone Reports Elsevier

Book Volume: 20

Article Number: 101732

DOI: 10.1016/j.bonr.2023.101732

Abstract

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.

Authors with CRIS profile

Klaus Engelke Lehrstuhl für Medizinische Physik und Mikrogewebetechnik

Involved external institutions

Beijing Jishuitan Hospital CN China (CN) Turku University Hospital / Turun yliopistollinen keskussairaala (TYKS) FI Finland (FI) Leiden University Medical Center NL Netherlands (NL) First People’s Hospital of Yunnan Province CN China (CN) Peking Union Medical College Hospital (PUMCH) / Beijing Xiehe Hospital CN China (CN) St Thomas' Hospital GB United Kingdom (GB) Kunming Medical University CN China (CN)

How to cite

APA:

Wang, L., Yang, M., Ge, Y., Liu, Y., Wang, G., Su, Y.,... Engelke, K. (2024). 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. Bone Reports, 20. https://doi.org/10.1016/j.bonr.2023.101732

MLA:

Wang, Ling, et al. "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." Bone Reports 20 (2024).

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