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Published in: Osteoporosis International 5/2019

01-05-2019 | Osteoporosis | Original Article

Discrimination of osteoporosis-related vertebral fractures by DXA-derived 3D measurements: a retrospective case-control study

Authors: M. López Picazo, L. Humbert, S. Di Gregorio, M. A. González Ballester, L.M. del Río Barquero

Published in: Osteoporosis International | Issue 5/2019

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Abstract

Summary

A retrospective case-control study assessing the association of DXA-derived 3D measurements with osteoporosis-related vertebral fractures was performed. Trabecular volumetric bone mineral density was the measurement that best discriminates between fracture and control groups.

Introduction

The aim of the present study was to evaluate the association of DXA-derived 3D measurements at the lumbar spine with osteoporosis-related vertebral fractures.

Methods

We retrospectively analyzed a database of 74 postmenopausal women: 37 subjects with incident vertebral fractures and 37 age-matched controls without any type of fracture. DXA scans at the lumbar spine were acquired at baseline (i.e., before the fracture event for subjects in the fracture group), and areal bone mineral density (aBMD) was measured. DXA-derived 3D measurements, such as volumetric BMD (vBMD), were assessed using a DXA-based 3D modeling software (3D-SHAPER). vBMD was computed at the trabecular, cortical, and integral bone. Cortical thickness and cortical surface BMD were also measured. Differences in DXA-derived measurements between fracture and control groups were evaluated using unpaired t test. Odds ratio (OR) and area under the receiver operating curve (AUC) were also computed. Subgroup analyses according to fractured vertebra were performed.

Results

aBMD of fracture group was 9.3% lower compared with control group (p < 0.01); a higher difference was found for trabecular vBMD in the vertebral body (− 16.1%, p < 0.001). Trabecular vBMD was the measurement that best discriminates between fracture and control groups, with an AUC of 0.733, against 0.682 for aBMD. Overall, similar findings were observed within the subgroup analyses. The L1 vertebral fractures subgroup had the highest AUC at trabecular vBMD (0.827), against aBMD (0.758).

Conclusion

This study showed the ability of cortical and trabecular measurements from DXA-derived 3D models to discriminate between fracture and control groups. Large cohorts need to be analyzed to determine if these measurements could improve fracture risk prediction in clinical practice.
Literature
4.
go back to reference Jalava T, Sarna S, Pylkka L et al (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1259CrossRefPubMed Jalava T, Sarna S, Pylkka L et al (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1259CrossRefPubMed
21.
34.
go back to reference Winzenrieth R, Humbert L, Di Gregorio S et al (2018) Effects of osteoporosis drug treatments on cortical and trabecular bone in the femur using DXA-based 3D modeling. Osteoporos Int 29:2323–2333CrossRefPubMed Winzenrieth R, Humbert L, Di Gregorio S et al (2018) Effects of osteoporosis drug treatments on cortical and trabecular bone in the femur using DXA-based 3D modeling. Osteoporos Int 29:2323–2333CrossRefPubMed
35.
go back to reference Van der Klift M, De Laet CE, McCloskey EV et al (2002) The incidence of vertebral fractures in men and women: the Rotterdam Study. J Bone Miner Res 17:1051–1056CrossRefPubMed Van der Klift M, De Laet CE, McCloskey EV et al (2002) The incidence of vertebral fractures in men and women: the Rotterdam Study. J Bone Miner Res 17:1051–1056CrossRefPubMed
37.
go back to reference Noshchenko A, Plaseied A, Patel V et al (2013) Correlation of vertebral strength topography with 3-dimensional computed tomographic structure. Spine (Phila Pa 1976) 38:339–349CrossRef Noshchenko A, Plaseied A, Patel V et al (2013) Correlation of vertebral strength topography with 3-dimensional computed tomographic structure. Spine (Phila Pa 1976) 38:339–349CrossRef
39.
go back to reference Jackman TM, Hussein AI, Curtiss C, Fein PM, Camp A, de Barros L, Morgan EF (2016) Quantitative, 3D visualization of the initiation and progression of vertebral fractures under compression and anterior flexion. J Bone Miner Metab 31:777–788. https://doi.org/10.1002/jbmr.2749 CrossRef Jackman TM, Hussein AI, Curtiss C, Fein PM, Camp A, de Barros L, Morgan EF (2016) Quantitative, 3D visualization of the initiation and progression of vertebral fractures under compression and anterior flexion. J Bone Miner Metab 31:777–788. https://​doi.​org/​10.​1002/​jbmr.​2749 CrossRef
Metadata
Title
Discrimination of osteoporosis-related vertebral fractures by DXA-derived 3D measurements: a retrospective case-control study
Authors
M. López Picazo
L. Humbert
S. Di Gregorio
M. A. González Ballester
L.M. del Río Barquero
Publication date
01-05-2019
Publisher
Springer London
Published in
Osteoporosis International / Issue 5/2019
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-019-04894-y

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