RELATIONSHIPS BETWEEN METACARPAL MORPHOMETRY, FOREARM AND VERTEBRAL BONE-DENSITY AND FRACTURES IN POSTMENOPAUSAL WOMEN

The relationships between metacarpal morphometric, vertebral and forea rm density measurements and the prevalence of vertebral and peripheral fractures were examined in 239 postmenopausal women (median age 63, r ange 32-84 years). Metacarpal cortical area/total area ratio (CA/TA) w as measured with needle calipers, forearm mineral density (FMD) by sin gle photon absorptiometry and vertebral mineral density (VMD) by singl e energy quantitative computed tomography. Of the 239 subjects 97 had not suffered any fractures, 44 had at least one previous vertebral fra cture but no peripheral fractures, 41 had a history of peripheral frac ture but no vertebral fracture and 57 had suffered both peripheral and vertebral fractures. There were significant correlations between a si ngle measurement of CA/TA and both FMD (r = 0.65, p < 0.001) and VMD ( r = 0.41, p < 0.001). Similar correlations existed between the mean of multiple measurements of CA/TA and both FMD and VMD. CA/TA (p < 0.001 ), FMD (p < 0.001) and VMD (p < 0.001) were reduced in subjects who ha d suffered fractures, when compared with the no fracture group. The pe rcentage of cases in each of the four fracture groups (vertebral fract ure only, peripheral fracture only, peripheral and vertebral fracture, peripheral or vertebral fracture) misclassified with reference to the no fracture group were similar with CA/TA, FMD or VMD measurements. W e suggest that metacarpal morphometry, which is widely available at re latively low cost, yields cross-sectional information about bone densi ty and fracture risk, comparable with that obtained by forearm and ver tebral densitometry.