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Change in vertebral strength and bone mineral density in men and women over the year post-hip fracture: a subgroup analysis

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Abstract

Summary

This study examines changes in bone density and strength in the spine over the year after hip fracture to see if there are differences in the changes between men and women. Results show losses in the spine that may increase the risk of subsequent vertebral fractures, particularly for women.

Purpose

Compare changes over the first year post-hip fracture in vertebral bone mineral density (BMD) and compressive strength, measured from quantitative computed tomography (QCT) scans of the spine (T12-L1), between women and men.

Methods

QCT scans were performed on 37 participants (21 men and 16 women) at 2 and 12 months post-hip fracture as part of an ancillary observational study of hip fracture recovery in older community-dwelling men and women. Vertebral BMD and compressive strength were calculated using VirtuOst® (O.N. Diagnostics, Berkeley, CA). Unpaired t-tests were used to compare men and women with respect to baseline demographics, measurements of BMD and bone strength for the whole vertebra and the cortical and trabecular compartments, and any changes in these parameters between months 2 and 12.

Results

At 2 months post-fracture, there were no significant sex differences in any measurements of vertebral strength or BMD. Between months 2 and 12, vertebral strength decreased significantly in women (− 3.8%, p < 0.05) but not in men (− 2.3%, p < 0.20), vertebral trabecular BMD decreased similarly in both sexes (− 5.7% women; − 6.0% men), but cortical BMD did not change for either sex.

Conclusion

Despite the small sample size, these findings suggest that appreciable loss of vertebral trabecular bone can occur for both sexes in the year following hip fracture, which may increase the risk of subsequent vertebral fracture, particularly for women.

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Data Availability

BHS-7 data contains potentially identifiable patient health information. Limited de-identified datasets and code are available to investigators upon request and approval by the study leadership group.

Code availability

BHS-7 data contains potentially identifiable patient health information. Limited de-identified datasets and code are available to investigators upon request and approval by the study leadership group.

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Acknowledgements

We would like to thank the staff at the Department of Radiology at the University of Maryland Medical Center (UMMC) for conducting the QCT scans for research participants. Finally, we thank all the hospital personnel of the recruitment sites for their support of the research.

Funding

This work was supported by grants from the National Institute on Aging at the National Institutes of Health (grant numbers R37 AG09901 MERIT Award, R01 AG029315, T32 AG00262, P30 AG028747). The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Public Health, School of Medicine, University of Maryland Baltimore, 660 West Redwood Street, Suite 200, Baltimore, MD, 21201, USA

    Denise L. Orwig, Jay Magaziner & Marc Hochberg

  2. O.N. Diagnostics, Berkeley, CA, USA

    David Kopperdahl

  3. Departments of Mechanical Engineering and Bioengineering, University of California Berkeley, Berkeley, CA, USA

    Tony Keaveny

  4. Department of Medicine, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA

    Marc Hochberg

Authors
  1. Denise L. Orwig
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  2. David Kopperdahl
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  4. Jay Magaziner
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  5. Marc Hochberg
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Contributions

Drs. Orwig and Kopperdahl had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Orwig, Kopperdahl, Keaveny, Magaziner, Hochberg.

Acquisition of data: Orwig, Magaziner, Hochberg.

Analysis and interpretation of data: all authors.

Drafting of the manuscript: Orwig, Kopperdahl, Hochberg

Critical revision of the manuscript for important intellectual content: all authors.

Statistical analysis: Kopperdahl

Obtained funding: all authors.

Corresponding author

Correspondence to Denise L. Orwig.

Ethics declarations

Ethics approval

Protocols for both the parent study and CT ancillary study were approved by the Institutional Review Boards (IRB) at the University of Maryland Baltimore, as well as by each study hospital’s respective IRBs.

Consent to participate

Informed consent was provided by the hip fracture patient or their proxy.

Consent for publication

Consent for publication of study results was contained within the Informed Consent Document.

Conflicts of interest

Denise Orwig and Marc Hochberg declare they have no conflicts of interest. David Kopperdahl is an employee of O.N. Diagnostics. Tony Keaveny is Founder and consulting Chief Scientific Officer, O.N. Diagnostics; consulting for Amgen, Agnovos Healthcare, Bone Health Technologies; equity in O.N. Diagnostics. Jay Magaziner has served on advisory boards or consulted for UCB and Pluristem.

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Orwig, D.L., Kopperdahl, D., Keaveny, T. et al. Change in vertebral strength and bone mineral density in men and women over the year post-hip fracture: a subgroup analysis. Arch Osteoporos 16, 37 (2021). https://doi.org/10.1007/s11657-021-00907-8

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  • DOI: https://doi.org/10.1007/s11657-021-00907-8

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