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BMD Predicts Fracture Risk in Men as Accurately as in Women


 

SEATTLE — Bone mineral density measurements are equally good predictors of fracture risk in men and in women, even though men have a lower fracture risk, according to a 3-year study of almost 6,000 older men.

Previous studies have shown that bone mineral density (BMD) measurement predicts risk of fracture in women, but until now it has not been confirmed that the same is true for men, said Peggy M. Cawthon at the annual meeting of the American Society for Bone and Mineral Research.

The Osteoporotic Fractures in Men study found that men with osteoporosis had a 10-fold greater risk of non-spine fracture and a 100-fold greater risk of hip fracture, compared with men with normal BMD, said Ms. Cawthon, of the Research Institute, California Pacific Medical Center, San Francisco.

In the study, spine and hip BMD were measured in the men, whose average age was 74 years. Over the course of the study, there were 211 total non-spine fractures, 21 in the 104 men with osteoporosis, and 39 hip fractures, 10 in those with osteoporosis.

When the subjects were divided into quartiles based on their bone mineral density T scores, fracture rates increased as quartile decreased such that men in the lowest quartile of T score for the total hip had four times the risk of hip fracture of those in the highest quartile. The average T score for the cohort was -0.58.

Total hip density was a stronger predictor of hip fracture than was spine density, and femoral neck density, spine density, and total hip density were all similarly predictive of total non-spine fractures.

The correlations showed that the relative risk of hip fracture increased by 3.6 times with each lower, total hip T score standard deviation, Ms. Cawthon said. The relative risk of any fracture increased 1.8 times for each standard deviation of total hip T score.

In women, the relative risk of hip fracture and any non-spine fracture increases 2.6 times and 1.5 times, respectively, for each lower standard deviation. A comparison of the rate of fracture for any T score in this study with the rate of fracture in a similar study of women indicates a much higher rate of fracture in women, she added.

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