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Evaluation of Compressive Strength Index of the Femoral Neck in Caucasians and Chinese

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Abstract

Compressive strength index (CSI) of the femoral neck is a parameter that integrates the information of bone mineral density (BMD), femoral neck width (FNW), and body weight. CSI is considered to have the potential to improve the performance of assessment for hip fracture risk. However, studies on CSI have been rare. In particular, few studies have evaluated the performance of CSI, in comparison with BMD, FNW, and bending geometry, for assessment of hip fracture risk. We studied two large populations, including 1683 unrelated U.S. Caucasians and 2758 unrelated Chinese adults. For all the study subjects, CSI, femoral neck BMD (FN_BMD), FNW, and bending geometry (section modulus [Z]) of the samples were obtained from dual-energy X-ray absorptiometry scans. We investigated the age-related trends of these bone phenotypes and potential sex and ethnic differences. We further evaluated the performance of these four phenotypes for assessment of hip fracture risk by logistic regression models. Chinese had significantly lower FN_BMD, FNW, and Z, but higher CSI than sex-matched Caucasians. Logistic regression analysis showed that higher CSI was significantly associated with lower risk of hip fracture, and the significance remained after adjusting for covariates of age, sex, and height. Each standard deviation (SD) increment in CSI was associated with odds ratios of 0.765 (95% confidence interval, 0.634, 0.992) and 0.724 (95% confidence interval, 0.569, 0.921) for hip fracture risk in Caucasians and Chinese, respectively. The higher CSI in Chinese may partially help explain the lower incidence of hip fractures in this population compared to Caucasians. Further studies in larger cohorts and/or longitudinal observations are necessary to confirm our findings.

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Acknowledgments

Investigators of this work were partially supported by Grants from the NIH (R01 AR050496, R21 AG027110, R01 AG026564, P50 AR055081, and R21 AA015973). The study also benefited from grants from National Science Foundation of China, Huo Ying Dong Education Foundation, HuNan Province, and the Ministry of Education of China. We are grateful to Kirk Redger for editing help.

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Authors and Affiliations

  1. Department of Pharmaceutical Toxicology, School of Pharmaceutical Science, China Medical University, Shenyang, People’s Republic of China

    Na Yu & Ji-Qun Cai

  2. School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA

    Na Yu, Yong-Jun Liu, Yufang Pei, Lei Zhang, Shufeng Lei, Niraj R. Kothari, Christopher J. Papasian, James Hamilton & Hong-Wen Deng

  3. Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, Hunan, People’s Republic of China

    Shufeng Lei & Hong-Wen Deng

  4. Section of Gastroenterology, Children’s Mercy Hospital, Kansas City, MO, USA

    Ding-You Li

  5. Departments of Basic Medical Science and Orthopedic Surgery, University of Missouri-Kansas City, 2411 Holmes Street, Room M3-C03, Kansas City, MO, 64108-2792, USA

    Hong-Wen Deng

Authors
  1. Na Yu
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  2. Yong-Jun Liu
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  4. Lei Zhang
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Correspondence to Ji-Qun Cai or Hong-Wen Deng.

Additional information

Na Yu and Yong-Jun Liu were co-first authors.

The authors have stated that they have no conflict of interest.

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Fig. 1

Properties of compressive strength index (CSI) distribution before and after adjustment for age and by sex in Caucasians. Mean is the average value of CSI; Std. Dev. is the standard deviation; N is the total number in plot. Supplementary material 1 (TIFF 382 kb)

Fig. 2

Properties of compressive strength index (CSI) distribution before and after adjustment for age and by sex in Chinese. Mean is the average value of CSI; Std. Dev. is the standard deviation; N is the total number in plot. Supplementary material 2 (TIFF 355 kb)

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Yu, N., Liu, YJ., Pei, Y. et al. Evaluation of Compressive Strength Index of the Femoral Neck in Caucasians and Chinese. Calcif Tissue Int 87, 324–332 (2010). https://doi.org/10.1007/s00223-010-9406-8

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  • DOI: https://doi.org/10.1007/s00223-010-9406-8

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