Short-term risk of fracture is increased by deficits in cortical and trabecular bone microarchitecture independent of DXA BMD and FRAX: Bone Microarchitecture International Consortium (BoMIC) prospective cohorts
Authors' conclusion
In older adults, FL and HR-pQCT measures of cortical and trabecular bone microarchitecture and density with strong associations to short-term fractures improved fracture prediction beyond aBMD and FRAX.
Study context
- Population
- Older adults in eight cohorts of the Bone Microarchitecture International Consortium (BoMIC); 4824 women, 2503 men, mean 69 ± 9 years; 7% FN T-score ≤ −2.5, 53% between −1.0 and −2.5, 37% ≥−1.0
- Participants
- 7,327 adults8 cohorts
- Exposure
- Per SD decrease in HR-pQCT bone microarchitecture and density measures
- Outcome
- Incidence of fracture (non-traumatic and traumatic)
- Follow-up
- 2 years
Methodological detailspooled data from eight cohorts, sex-specific analyses, adjusted for age, cohort, height and weight, then for FN aBMD or FRAX
- Pooled data from eight cohorts
- Sex-specific analyses
- Adjusted for age, cohort, height and weight, then for FN aBMD or FRAX
Main finding
As reported in the abstract
2-year fracture risk per SD decrease in bone measures
- Two-year cumulative fracture incidence
- 4% (296/7327)
- Increase in fracture risk per SD decrease in radius cortical bone measures, women and men
- 38%-76%
- Increase in fracture risk per SD decrease in radius cortical measures after additional adjustment for FN-aBMD
- 28%-61%
- Radius trabecular measures, women, HR per SD independent of FN-aBMD (trabecular separation to total vBMD)
- 1.21 to 1.55
- Decreased failure load, women and men, FN-aBMD-adjusted HR range
- 1.47-2.42
Observational data: associations, not effects.
Original publication
Short-term risk of fracture is increased by deficits in cortical and trabecular bone microarchitecture independent of DXA BMD and FRAX: Bone Microarchitecture International Consortium (BoMIC) prospective cohorts. J Bone Miner Res. Published 5 September 2024. doi:10.
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