Central tibia marrow density is associated with incident fractures among postmenopausal females
Authors' conclusion
Our findings suggested that central tibia marrow density as quantified by pQCT is a proxy for marrow composition that reveals important 4 to 7-yr risk of fragility fractures among postmenopausal females. These results highlight the potential of marrow density as a separate risk factor for fractures from bone density, warranting further investigation as a potential contributor to fracture risk pending external validation.
Study context
- Population
- Postmenopausal females aged 60–85 yr, Appendicular Muscle and Bone Extension Research Study (AMBERS) cohort
- Participants
- 312 females
- Exposure
- Lower vs higher tibial marrow density
- Outcome
- Time to first X-ray-confirmed incident fragility fracture
- Follow-up
- 7 years
Methodological detailslongitudinal, Cox proportional hazards models, competing risk (against mortality), conditional Cox models, adjusted for age, BMI, diabetes/hypertension, hypo/hyperthyroidism, antiresorptive usage, osteoarthritis, physical activity, lumbar spine BMD and trabecular tissue mineral density
- Longitudinal
- Cox proportional hazards models
- Competing risk (against mortality)
- Conditional Cox models
- Adjusted for age, BMI, diabetes/hypertension, hypo/hyperthyroidism, antiresorptive usage, osteoarthritis, physical activity, lumbar spine BMD and trabecular tissue mineral density
Main finding
As reported in the abstract
Incident fracture
41
13.1%
Lower central marrow density, distal slice: HR per SD
1.81(1.21, 2.71) (CI level not stated)
Lower central marrow density, proximal slice: HR
1.58(1.06, 2.36) (CI level not stated)
Peripheral marrow density, intermediate vs highest levels: increased fracture risk
2.65(1.19, 5.92) (CI level not stated)
Observational data: associations, not effects.
Original publication
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