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Relationship between long-term changes in femoral neck bone mineral density and hip fracture incidence in untreated postmenopausal osteoporotic women

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[2008] [FRI0379] RELATIONSHIP BETWEEN LONG-TERM CHANGES IN FEMORAL NECK BONE MINERAL DENSITY AND HIP FRACTURE INCIDENCE IN UNTREATED POSTMENOPAUSAL OSTEOPOROTIC WOMEN

O. Bruyere1, M. Brandi2, B. Vellas3, M. Hiligsmann4, J. Reginster41Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium; 2Department of internal medicine, Firenze Hospital, Firenze, Italy; 3Gerontopole; 4

Public Health, Epidemiology and Health Economics, CHU, Toulouse, France

Background: Meta-analysis have shown an increase in hip fracture risk in patients with a low hip bone mineral density (BMD). However, the relationship between BMD loss and hip fracture risk has poorly been studied.

Methods: Femoral neck BMD was assessed at baseline and after a follow-up of 3 years in women from the placebo group of the SOTI and TROPOS trials. SOTI and TROPOS were two recent studies having assessed the anti-fracture efficacy of strontium ranelate in osteoporosis. Hip fractures were based on written documentation. All patients received calcium and vitamin D during 3 years.

Results: Out of the 1933 women included in this study, 36 (1.9%) have experienced a hip fracture during the 3 years of follow-up. The logistic regression analysis, including age, body mass index, prevalent vertebral fracture and baseline femoral neck BMD as covariates, showed that 3-year change in femoral neck BMD was statistically associated with the incidence of hip fracture after 3 years (p=0.001). For each decrease of 1% in femoral neck BMD, the risk to experience a new hip fracture after 3 years increased by 7% (95%CI 3%-12%). Patients within the first quartile of femoral neck BMD change (<-5.49%) have

experienced 22 hip fractures (4.6%) compared to 7 fractures (1.5%) in patients within the forth quartile (>+0.68%). The risk to experience a hip fracture in patients with the highest femoral neck BMD less is more than 3-fold greater than in patients within the smallest BMD less (p=0.005).

Conclusion: In this elderly population, the highest decrease in femoral neck BMD is associated with the highest hip fracture incidence.

Ann Rheum Dis 2008;67(Suppl II):403 Osteoporosis

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