Discrimination of osteoporosis-related vertebral fractures by DXA-derived 3D measurements: a retrospective case-control study

• Published in: Osteoporosis international 2019-05, Vol.30 (5), p.1099-1110
• Main Authors: López Picazo, M., Humbert, L., Di Gregorio, S., González Ballester, M. A., del Río Barquero, L.M.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Adult; Aged; Bone Density; Bone mineral density; Cancellous bone; Case-Control Studies; Cortical bone; Dual energy X-ray absorptiometry; Endocrinology; Female; Fractures; Humans; Imaging, Three-Dimensional - methods; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - injuries; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Osteoporosis; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - physiopathology; Post-menopause; Retrospective Studies; Rheumatology; Spinal Fractures - diagnostic imaging; Spinal Fractures - physiopathology; Spine (lumbar); Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; Vertebrae
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-019-04894-y

Summary A retrospective case-control study assessing the association of DXA-derived 3D measurements with osteoporosis-related vertebral fractures was performed. Trabecular volumetric bone mineral density was the measurement that best discriminates between fracture and control groups. Introduction The aim of the present study was to evaluate the association of DXA-derived 3D measurements at the lumbar spine with osteoporosis-related vertebral fractures. Methods We retrospectively analyzed a database of 74 postmenopausal women: 37 subjects with incident vertebral fractures and 37 age-matched controls without any type of fracture. DXA scans at the lumbar spine were acquired at baseline (i.e., before the fracture event for subjects in the fracture group), and areal bone mineral density (aBMD) was measured. DXA-derived 3D measurements, such as volumetric BMD (vBMD), were assessed using a DXA-based 3D modeling software (3D-SHAPER). vBMD was computed at the trabecular, cortical, and integral bone. Cortical thickness and cortical surface BMD were also measured. Differences in DXA-derived measurements between fracture and control groups were evaluated using unpaired t test. Odds ratio (OR) and area under the receiver operating curve (AUC) were also computed. Subgroup analyses according to fractured vertebra were performed. Results aBMD of fracture group was 9.3% lower compared with control group ( p