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Differences in the trajectory of bone mineral density change measured at the total hip and femoral neck between men and women following hip fracture

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Abstract

Summary

Research has not examined changes in bone mineral density (BMD) between men and women following hip fracture. The aim was to evaluate sex differences in BMD following hip fracture. Men experienced significant declines in BMD, while not statistically greater than women, underscoring the necessity for better osteoporosis care in men.

Introduction

Each year in the USA, approximately 260,000 older adults experience a hip fracture. Women experiencing hip fracture have excess decline in BMD in the year following fracture compared to expected decrements due to aging, but few studies have assessed sex differences in the sequelae of hip fracture. Thus, our objective was to examine sex differences in BMD change in the year after hip fracture.

Methods

The sample (n = 286) included persons enrolled in the Baltimore Hip Studies 7th cohort, a study that matched (1:1) men and women experiencing hip fracture. Weighted estimating equations that accounted for missing data and selective survival were used to estimate sex differences in 12-month total hip (TH) and femoral neck (FN) BMD changes.

Results

Men had larger average adjusted percent decline in TH and FN BMD. Adjusted 12-month decreases at the FN showed a statistically significant decline of −4.60 % (95 % confidence interval [CI] −7.76 %, −0.20 %) in men and an insignificant change of −1.62 % (95 % CI −4.57 %, 1.32 %) in women. Yet, the difference in change between men and women was not statistically significant (P = 0.17). The estimated sex differences for TH BMD loss were smaller in magnitude.

Conclusions

There is evidence of significant BMD loss among men at the FN in the year after hip fracture. Although not statistically greater than women, these clinically significant findings highlight the need for improved osteoporosis care among men prior to and after hip fracture.

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Acknowledgments

This research was supported by grants from the National Institute on Aging (R37 AG009901, R01 AG029315, P30 AG028747, T32 AG00262). We also acknowledge the cooperation of the hospitals, DXA facilities, residents, and families participating in this project.

Author information

Authors and Affiliations

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

    Alan M. Rathbun, Denise Orwig, J. Richard Hebel, Marc C. Hochberg & Jay Magaziner

  2. National Institute on Aging, 251 Bayview Blvd, Baltimore, MD, 21224, USA

    Michelle Shardell

  3. University of Delaware, 540 S. College Ave, Suite 210E, Newark, DE, 19713, USA

    Gregory E. Hicks

  4. Beck Radiological Innovations, 922 Rambling Drive, Catonsville, MD, 21228, USA

    Thomas Beck

Authors
  1. Alan M. Rathbun
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  2. Michelle Shardell
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  3. Denise Orwig
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  4. J. Richard Hebel
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  5. Gregory E. Hicks
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  6. Thomas Beck
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  7. Marc C. Hochberg
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  8. Jay Magaziner
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Corresponding author

Correspondence to Alan M. Rathbun.

Ethics declarations

This observational research was conducted in accordance with the ethical standards of the Declaration of Helsinki, and the protocols for this study were reviewed and approved by the University of Maryland Institutional Review Board (IRB) and the review boards of participating hospitals.

Conflicts of interest

Dr. Jay Magaziner has consulting agreements with Ammonett, Novartis, Sanofi, and Viking. Dr. Denise Orwig has consulting agreements with Kinexum and Viking. Dr. Thomas Beck is CEO of Beck Radiological Innovations Inc. Drs. Alan M. Rathbun, Michelle Shardell, J. Richard Hebel, Gregory E. Hicks, and Marc C. Hochberg have no disclosures to declare.

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Rathbun, A.M., Shardell, M., Orwig, D. et al. Differences in the trajectory of bone mineral density change measured at the total hip and femoral neck between men and women following hip fracture. Arch Osteoporos 11, 9 (2016). https://doi.org/10.1007/s11657-016-0263-6

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  • DOI: https://doi.org/10.1007/s11657-016-0263-6

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