FEMORAL AND SPINAL BONE-MINERAL DENSITY IN JAPANESE OSTEOPOROTICS WITH HIP FRACTURE

In the present study, bone mineral density (BMD) of femoral neck and l umbar spine was compared between 38 Japanese female Patients with hip fracture (age 63-89 years, mean+/-SD 76+/07 years) and 162 age-matched female controls (age 62-90 years, mean+/-SD 75+/-7 years). BMD was me asured in the femoral neck and lumbar spine (L2-4) using dual-photon a bsorptiometry (Norland model 2600). BMD values of femoral neck as well as lumbar spine were significantly lower in patients with hip fractur e than in controls (0.504+/-0.097 v 0.597+/-0.101, p<0.01, for femoral neck; 0.661+/-0.146 v 0.720+/-0.128, p<0.05, for lumbar spine). Patie nts with hip fracture and controls were stratified according to their BMD levels at two measuring sites, and the ratio of the number of pati ents and controls at each BMD level was calculated as an indicator of fracture rate. This ratio showed an exponential increase as the femora l neck BMD declined, but only a gradual increase as the lumbar spine B MD declined. Specificity-sensitivity analysis revealed that BMD values of 0.59 and 0.54 g/cm2 at the femoral neck provided a specificity of 52% and 68% with a sensitivity of 90% and 75%, respectively. These fin dings suggest that Japanese patients with hip fracture are more osteop orotic than age-matched controls and that the selective measurement of femoral neck would be useful for predicting the risk of hip fracture.