Male-female differences in the association between incident XXXX and proximal femoral strength: a finite element analysis study.

@entity1 @entity173 @entity170 @entity174
@entity173 risk is usually evaluated using dual energy X-ray absorptiometry (DXA) or quantitative computed tomography (QCT) which provide surrogate measures for proximal femoral strength. However, proximal femoral strength can best be estimated explicitly by combining QCT with finite element (FE) analysis. To evaluate this technique for predicting @entity173 in older @entity1 and @entity1 , we performed a nested age- and sex-matched case-control study in the Age Gene/Environment Susceptibility (AGES) Reykjavik cohort. Baseline (pre- @entity174 ) QCT scans of 5500 subjects were obtained. During 4-7 years follow-up, 51 @entity1 and 77 @entity1 sustained @entity173 . Ninety-seven @entity1 and 152 @entity1 were randomly selected as age- and sex-matched controls. FE-strength of the left hip of each subject for stance (F(Stance)) and posterolateral fall (F(Fall)) loading, and total femur areal bone mineral density (aBMD) were computed from the QCT data. F(Stance) and F(Fall) in incident @entity173 subjects were 13%-25% less than in control subjects (p  <= 0.006) after controlling for demographic parameters. The difference between FE strengths of @entity174 and control subjects was disproportionately greater in @entity1 (stance, 22%; fall, 25%) than in @entity1 (stance, 13%; fall, 18%) (p  <= 0.033), considering that F(Stance) and F(Fall) in @entity174 subjects were greater in @entity1 than in @entity1 (p < 0.001). For @entity1 , F(Stance) was associated with @entity173 after accounting for aBMD (p = 0.013). These data indicate that F(Stance) provides information about @entity174 risk that is beyond that provided by aBMD (p = 0.013). These findings support further exploration of possible sex differences in the predictors of @entity173 and of sex-specific strategies for using FE analysis to manage @entity170 .
