Femoral neck width is associated with unique trajectories of age-related hip structural changes and fracture risk within populations of adult women and men

Osteoporosis management relies heavily on areal BMD (aBMD) to identify women and men with reduced bone strength. We tested the hypothesis that baseline FN external size is associated with different bone-loss and area-gain trajectories that are not reflected in aBMD-decline but have different biomechanical implications. We analyzed data from 4 longitudinal studies with repeated hip DXA scans of women and men over 10-15 yr of follow-up. Changes in FN BMC, area, and aBMD were compared across height-adjusted baseline FN area tertiles using linear models. Fracture risk differences across the tertiles were tested using Cox proportional-hazard models. Women and men with smaller baseline FN area had smaller BMC-declines and greater area-increases over 10-15 yr. In contrast, those with a larger FN area experienced twice the annual BMC-declines but much smaller area-increases. In general, these structural changes were not reflected in aBMD-changes for either sex. The likelihood of fracturing a hip was 2.5 times greater for women and 2.4-4.2 times greater for men in the larger FN area tertile compared to those in the smaller FN area tertile. Unique patterns of age-related structural changes with different biomechanical implications were identified within populations of women and men. These results challenge the general assumption that age-related structural changes are homogenous within a population and question whether aBMD-declines reflect strength-declines consistently among women and men. How these unique patterns of structural change affect the response of women and men to osteoporosis interventions remains to be determined.

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Publication Details

Journal
Journal of Bone and Mineral Research
Published
2025-06-28
DOI
https://doi.org/10.1093/jbmr/zjaf090
Citations
4
Primary Topic
Bone health and osteoporosis research
Type
article
Field-Weighted Citation Impact
6.89

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article

Femoral neck width is associated with unique trajectories of age-related hip structural changes and fracture risk within populations of adult women and men

Aleda M. Leis, Eric Orwoll, Michael R. Elliott, Karl J. Jepsen et al.
4 citations
Journal of Bone and Mineral Research
Bone health and osteoporosis research
6.89
article

Femoral neck width is associated with unique trajectories of age-related hip structural changes and fracture risk within populations of adult women and men

Aleda M. Leis, Eric Orwoll, Michael R. Elliott, Karl J. Jepsen, Jane A. Cauley, Steffenie Merillat, Peggy M. Cawthon, Todd L. Bredbenner, Gregory A. Clines, Gail A. Greendale, Carrie Karvonen‐Gutierrez, Michelle M. Hood, Arun S. Karlamangla, John F. Randolph, Sioḃán D. Harlow, Stephanie Litwack Harrison, Li‐Yung Lui, Katherine W. Peters
article en
4 citations

Abstract

Osteoporosis management relies heavily on areal BMD (aBMD) to identify women and men with reduced bone strength. We tested the hypothesis that baseline FN external size is associated with different bone-loss and area-gain trajectories that are not reflected in aBMD-decline but have different biomechanical implications. We analyzed data from 4 longitudinal studies with repeated hip DXA scans of women and men over 10-15 yr of follow-up. Changes in FN BMC, area, and aBMD were compared across height-adjusted baseline FN area tertiles using linear models. Fracture risk differences across the tertiles were tested using Cox proportional-hazard models. Women and men with smaller baseline FN area had smaller BMC-declines and greater area-increases over 10-15 yr. In contrast, those with a larger FN area experienced twice the annual BMC-declines but much smaller area-increases. In general, these structural changes were not reflected in aBMD-changes for either sex. The likelihood of fracturing a hip was 2.5 times greater for women and 2.4-4.2 times greater for men in the larger FN area tertile compared to those in the smaller FN area tertile. Unique patterns of age-related structural changes with different biomechanical implications were identified within populations of women and men. These results challenge the general assumption that age-related structural changes are homogenous within a population and question whether aBMD-declines reflect strength-declines consistently among women and men. How these unique patterns of structural change affect the response of women and men to osteoporosis interventions remains to be determined.

Journal of Bone and Mineral ResearchVol. 40(10)
University of California, Los Angeles (US), Oregon Health & Science University (US), University of Pittsburgh (US), University of Michigan (US), California Pacific Medical Center (US), Michigan Medicine (US), University of Colorado Colorado Springs (US)
U.S. Department of Health and Human Services, Massachusetts General Hospital, Rush University, National Institutes of Health, University of California, Los Angeles, National Institute on Aging, National Institute of Nursing Research, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Office of Research on Women's Health, National Center for Advancing Translational Sciences
Good health and well-being
Openalex Percentile: Top 3%
Bone health and osteoporosis research
6.89
DOIOpen Access PDFOpenAlex
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