Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian women

Introduction: Although measuring bone mineral density (BMD) with dual X-ray absorptiometry (DXA) represents the standard of diagnosis and management of osteoporosis, there is a significant number of fragility fractures occurring in young patients without low BMD. Recently, clinical risk tools includ...

Full description

Saved in:
Bibliographic Details
Main Authors: Irina Manuela Nistor, Simona Fica, Sorina Carmen Martin, Marius Lucian Mitrache, Theodor Eugen Oprea, Anca Elena Sirbu, Carmen Gabriela Barbu
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Therapeutic Advances in Endocrinology and Metabolism
Online Access:https://doi.org/10.1177/20420188251332082
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850124161380253696
author Irina Manuela Nistor
Simona Fica
Sorina Carmen Martin
Marius Lucian Mitrache
Theodor Eugen Oprea
Anca Elena Sirbu
Carmen Gabriela Barbu
author_facet Irina Manuela Nistor
Simona Fica
Sorina Carmen Martin
Marius Lucian Mitrache
Theodor Eugen Oprea
Anca Elena Sirbu
Carmen Gabriela Barbu
author_sort Irina Manuela Nistor
collection DOAJ
description Introduction: Although measuring bone mineral density (BMD) with dual X-ray absorptiometry (DXA) represents the standard of diagnosis and management of osteoporosis, there is a significant number of fragility fractures occurring in young patients without low BMD. Recently, clinical risk tools included hip axis length (HAL), a geometric parameter derived from the hip DXA scan, as a predictor of hip fractures in older postmenopausal women. This study aims to evaluate the relationship between HAL and other cortical bone fractures in young postmenopausal, clinically healthy women. Materials and methods: This study is a retrospective analysis of Lunar DXA scans of 206 normal or overweight Caucasian women aged 40–60, who had less than 10 years of menopause without secondary causes of osteoporosis, no prior osteoporosis diagnosis or medication, and no history of hip or vertebral fractures. Results: The 15 fractured women displayed statistically greater HAL values compared to the 191 non-fractured subjects (109.43 ± 6.44 vs 104.81 ± 5.32 mm, p  = 0.002), even though there were no significant differences in age, body mass index, or BMD. The difference in HAL remained significant after adjusting for lumbar spine (LS) BMD and height (108.49 ± 1.23 vs 104.88 ± 0.34 mm, p  = 0.005). HAL proved to be a fair indicator of non-hip, non-vertebral cortical fractures (area under curve = 0.720, p  = 0.003), with a sensitivity of 86.7% and a specificity of 55.5%. Conclusion: HAL was positively associated with non-hip, non-vertebral cortical bone fragility fractures in young postmenopausal, clinically healthy women and had significantly greater values in the fractured subgroup even after adjusting for LS BMD and height.
format Article
id doaj-art-0aa5940381d341f0a92f2347f7e6941f
institution OA Journals
issn 2042-0196
language English
publishDate 2025-05-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Endocrinology and Metabolism
spelling doaj-art-0aa5940381d341f0a92f2347f7e6941f2025-08-20T02:34:24ZengSAGE PublishingTherapeutic Advances in Endocrinology and Metabolism2042-01962025-05-011610.1177/20420188251332082Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian womenIrina Manuela NistorSimona FicaSorina Carmen MartinMarius Lucian MitracheTheodor Eugen OpreaAnca Elena SirbuCarmen Gabriela BarbuIntroduction: Although measuring bone mineral density (BMD) with dual X-ray absorptiometry (DXA) represents the standard of diagnosis and management of osteoporosis, there is a significant number of fragility fractures occurring in young patients without low BMD. Recently, clinical risk tools included hip axis length (HAL), a geometric parameter derived from the hip DXA scan, as a predictor of hip fractures in older postmenopausal women. This study aims to evaluate the relationship between HAL and other cortical bone fractures in young postmenopausal, clinically healthy women. Materials and methods: This study is a retrospective analysis of Lunar DXA scans of 206 normal or overweight Caucasian women aged 40–60, who had less than 10 years of menopause without secondary causes of osteoporosis, no prior osteoporosis diagnosis or medication, and no history of hip or vertebral fractures. Results: The 15 fractured women displayed statistically greater HAL values compared to the 191 non-fractured subjects (109.43 ± 6.44 vs 104.81 ± 5.32 mm, p  = 0.002), even though there were no significant differences in age, body mass index, or BMD. The difference in HAL remained significant after adjusting for lumbar spine (LS) BMD and height (108.49 ± 1.23 vs 104.88 ± 0.34 mm, p  = 0.005). HAL proved to be a fair indicator of non-hip, non-vertebral cortical fractures (area under curve = 0.720, p  = 0.003), with a sensitivity of 86.7% and a specificity of 55.5%. Conclusion: HAL was positively associated with non-hip, non-vertebral cortical bone fragility fractures in young postmenopausal, clinically healthy women and had significantly greater values in the fractured subgroup even after adjusting for LS BMD and height.https://doi.org/10.1177/20420188251332082
spellingShingle Irina Manuela Nistor
Simona Fica
Sorina Carmen Martin
Marius Lucian Mitrache
Theodor Eugen Oprea
Anca Elena Sirbu
Carmen Gabriela Barbu
Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian women
Therapeutic Advances in Endocrinology and Metabolism
title Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian women
title_full Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian women
title_fullStr Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian women
title_full_unstemmed Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian women
title_short Hip axis length and non-hip cortical fragility fractures in young postmenopausal nonobese Caucasian women
title_sort hip axis length and non hip cortical fragility fractures in young postmenopausal nonobese caucasian women
url https://doi.org/10.1177/20420188251332082
work_keys_str_mv AT irinamanuelanistor hipaxislengthandnonhipcorticalfragilityfracturesinyoungpostmenopausalnonobesecaucasianwomen
AT simonafica hipaxislengthandnonhipcorticalfragilityfracturesinyoungpostmenopausalnonobesecaucasianwomen
AT sorinacarmenmartin hipaxislengthandnonhipcorticalfragilityfracturesinyoungpostmenopausalnonobesecaucasianwomen
AT mariuslucianmitrache hipaxislengthandnonhipcorticalfragilityfracturesinyoungpostmenopausalnonobesecaucasianwomen
AT theodoreugenoprea hipaxislengthandnonhipcorticalfragilityfracturesinyoungpostmenopausalnonobesecaucasianwomen
AT ancaelenasirbu hipaxislengthandnonhipcorticalfragilityfracturesinyoungpostmenopausalnonobesecaucasianwomen
AT carmengabrielabarbu hipaxislengthandnonhipcorticalfragilityfracturesinyoungpostmenopausalnonobesecaucasianwomen