Different Pattern of T-Score Discordance between Patients with Atypical Femoral Fracture and Femur Neck Fracture
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Our study evaluated the prevalence and pattern of T-score discordance between the spine and hip in Korean patients with atypical femoral fracture (AFF) and femur neck fracture (FNF). Methods: A total of 49 patients (all women) who were treated for AFF and 1:3 matched 147 female patients with FNF were included from January 2012 to August 2022. A discordance of more than 1.5 between lumbar spine and femur neck bone mineral density (BMD) was defined as a difference and divided into 3 groups: lumbar low (LL; lumbar BMD is less than femur neck BMD), no discordance (ND), and femur neck low (FL; femur neck BMD is less than lumbar BMD). We compared the prevalence and pattern of discordance between 2 groups, and the associated risk factors of T-score discordance among the subjects were evaluated using regression analysis. Results: The prevalence of discordance was significantly higher in patients with AFF (51%) than in those with FNF (25.2%; P<0.001). LL discordance was found in 46.9% of the patients with AFF but only 4.8% in those with FNF. Conversely, FL discordance was found in 4.1% of the patients with AFF and 20.4% in those with FNF, respectively. No specific risk factor was found as T-score discordance in the 2 groups. Conclusions: Clinicians should be aware that the pattern of T-score discordance can vary depending on the location of osteoporotic fractures. In addition, a longitudinal study would be necessary to verify the pattern of T-score discordance related to the osteoporotic fracture location.
Abstract
Background: Our study evaluated the prevalence and pattern of T-score discordance between the spine and hip in Korean patients with atypical femoral fracture (AFF) and femur neck fracture (FNF). Methods: A total of 49 patients (all women) who were treated for AFF and 1:3 matched 147 female patients with FNF were included from January 2012 to August 2022. A discordance of more than 1.5 between lumbar spine and femur neck bone mineral density (BMD) was defined as a difference and divided into 3 groups: lumbar low (LL; lumbar BMD is less than femur neck BMD), no discordance (ND), and femur neck low (FL; femur neck BMD is less than lumbar BMD). We compared the prevalence and pattern of discordance between 2 groups, and the associated risk factors of T-score discordance among the subjects were evaluated using regression analysis. Results: The prevalence of discordance was significantly higher in patients with AFF (51%) than in those with FNF (25.2%; P<0.001). LL discordance was found in 46.9% of the patients with AFF but only 4.8% in those with FNF. Conversely, FL discordance was found in 4.1% of the patients with AFF and 20.4% in those with FNF, respectively. No specific risk factor was found as T-score discordance in the 2 groups. Conclusions: Clinicians should be aware that the pattern of T-score discordance can vary depending on the location of osteoporotic fractures. In addition, a longitudinal study would be necessary to verify the pattern of T-score discordance related to the osteoporotic fracture location.
참고문헌 (28)
- Chukir T, "Clinical characteristics and fracture patterns among postmenopausal women with isolated osteoporosis at the forearm", J Clin Densitom, 25, pp.208~214 (2022)[DOI]
- Masud T, "Preventing osteoporotic fractures with bisphosphonates : a review of the efficacy and tolerability", Aging Clin Exp Res, 15, pp.89~98 (2003)[DOI]
- Glüer CC, "30years of DXA technology innovations", Bone, 104, pp.7~12 (2017)[DOI]
- Larcos G, "Predicting clinical discordance of bone mineral density", Mayo Clin Proc, 73, pp.824~828 (1998)[DOI]
- El Maghraoui A, "Prevalence and risk factors of discordance in diagnosis of osteoporosis using spine and hip bone densitometry", Ann Rheum Dis, 66, pp.271~272 (2007)[DOI]
- Moayyeri A, "Discordance in diagnosis of osteoporosis using spine and hip bone densitometry", BMC Endocr Disord, 5, pp.3~ (2005)[DOI]
- Yun Seong Choi, "Comparative Analysis of T-Score Discordance between a Registry-Based Korean Population and Atypical Femoral Fracture Patients of a Single Institution", Clinics in Orthopedic Surgery, 14(3), pp.352~360 (2022), 대한정형외과학회[DOI]
- Lee KJ, "T-score discordance of bone mineral density in patients with atypical femoral fracture", J Bone Joint Surg Am, 99, pp.1683~1688 (2017)[DOI]
- 이경학, "Prevalence, Clinical Implication, and Cause of Spine Hip Discordance in Elderly Patients with Fragility Hip Fracture", 대한골대사학회지, 29(1), pp.51~57 (2022), 대한골대사학회
- Byung-Ho Yoon, "Prevalence and Risk Factors of T-Score Spine-Hip Discordance in Patients with Osteoporotic Vertebral Compression Fracture", 대한골대사학회지, 29(1), pp.43~49 (2022), 대한골대사학회
- Alexandru D, "Evaluation and management of vertebral compression fractures", Perm J, 16, pp.46~51 (2012)[DOI]
- Diacinti D, "How to define an osteoporotic vertebral fracture?", Quant Imaging Med Surg, 9, pp.1485~1494 (2019)[DOI]
- Woodson G, "Dual X-ray absorptiometry T-score concordance and discordance between the hip and spine measurement sites", J Clin Densitom, 3, pp.319~324 (2000)[DOI]
- 윤병호, "Discordance between Hip and Spine Bone Mineral Density: A Point of Care", 대한골대사학회지, 28(4), pp.249~251 (2021), 대한골대사학회
- Leslie WD, "Spine-hip discordance and fracture risk assessment : a physician-friendly FRAX enhancement", Osteoporos Int, 22, pp.839~847 (2011)[DOI]
- McMahon K, "Discordance in lumbar spine T-scores and nonstandardization of standard deviations", J Clin Densitom, 6, pp.1~6 (2003)[DOI]
- Nugent SD, "Discordance between body mass index(BMI)and a novel body composition change index(BCCI)as outcome measures in weight change interventions", J Am Coll Nutr, 37, pp.302~307 (2018)[DOI]
- McMahon K, "Discordance in DXA male reference ranges", J Clin Densitom, 7, pp.121~126 (2004)[DOI]
- Hong AR, "Metabolic characteristics of subjects with spine-femur bone mineral density discordances : the Korean National Health and Nutrition Examination Survey(KNHANES 2008-2011)", J Bone Miner Metab, 37, pp.835~843 (2019)[DOI]
- Alarkawi D, "Contribution of lumbar spine BMD to fracture risk in individuals with T-score discordance", J Bone Miner Res, 31, pp.274~280 (2016)[DOI]
- Younes M, "Discordance between spine and hip bone mineral density measurement using DXA in osteoporosis diagnosis : Prevalence and risk factors", Tunis Med, 92, pp.1~5 (2014)
- Abrahamsen B, "Discordance between changes in bone mineral density measured at different skeletal sites in perimenopausal women--implications for assessment of bone loss and response to therapy : The Danish Osteoporosis Prevention Study", J Bone Miner Res, 16, pp.1212~1219 (2001)[DOI]
- Lee YK, "Atypical subtrochanteric fractures in Korean hip fracture study", Osteoporos Int, 28, pp.2853~2858 (2017)[DOI]
- Larsen MS, "The enigma of atypical femoral fractures : A summary of current knowledge", EFORT Open Rev, 3, pp.494~500 (2018)[DOI]
- Goh TS, "Spine-Hip Discordance and FRAX assessment Fracture Risk in Postmenopausal Women with Osteopenia from Concordant Diagnosis Between Lumbar Spine and Femoral Neck", J Clin Densitom, 24, pp.548~556 (2021)[DOI]
- Leslie WD, "Impact of spine-hip discordance on fracture risk assessment and treatment qualification in Canada : the Manitoba BMD registry", Arch Osteoporos, 15, pp.85~ (2020)[DOI]
- Chan CY, "Prevalence and factors of T-score discordance between hip and spine among middle-aged and elderly Malaysians", Arch Osteoporos, 15, pp.142~ (2020)[DOI]
- Seok H, "High prevalence of spine–femur bone mineral density discordance and comparison of vertebral fracture risk assessment using femoral neck and lumbar spine bone density in Korean patients", J Bone Miner Metab, 32, pp.405~410 (2014)[DOI]