Dataset Information

High bone mass is associated with an increased prevalence of joint replacement: a case-control study.

ABSTRACT:

Objective

Epidemiological studies have shown an association between OA and increased BMD. To explore the nature of this relationship, we examined whether the risk of OA is increased in individuals with high bone mass (HBM), in whom BMD is assumed to be elevated due to a primary genetic cause.

Methods

A total of 335,115 DXA scans were screened to identify HBM index cases (defined by DXA scan as an L1 Z-score of ?+3.2 and total hip Z-score ?+1.2, or total hip Z-score ?+3.2 and L1 Z-score ?+1.2). In relatives, the definition of HBM was L1 Z-score plus total hip Z-score ?+3.2. Controls comprised unaffected relatives and spouses. Clinical indicators of OA were determined by structured assessment. Analyses used logistic regression adjusting for age, gender, BMI and social deprivation.

Results

A total of 353 HBM cases (mean age 61.7 years, 77% female) and 197 controls (mean age 54.1 years, 47% female) were included. Adjusted NSAID use was more prevalent in HBM cases versus controls [odds ratio (OR) 2.17 (95% CI 1.10, 4.28); P = 0.03]. The prevalence of joint replacement was higher in HBM cases (13.0%) than controls (4.1%), with an adjusted OR of 2.42 (95% CI 1.06, 5.56); P = 0.04. Adjusted prevalence of joint pain and knee crepitus did not differ between cases and controls.

Conclusion

HBM is associated with increased prevalence of joint replacement surgery and NSAID use compared with unaffected controls.

SUBMITTER: Hardcastle SA

PROVIDER: S-EPMC3651613 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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Publications

High bone mass is associated with an increased prevalence of joint replacement: a case-control study.

Hardcastle Sarah A SA Gregson Celia L CL Deere Kevin C KC Davey Smith George G Dieppe Paul P Tobias Jon H JH

Rheumatology (Oxford, England) 20130128 6

<h4>Objective</h4>Epidemiological studies have shown an association between OA and increased BMD. To explore the nature of this relationship, we examined whether the risk of OA is increased in individuals with high bone mass (HBM), in whom BMD is assumed to be elevated due to a primary genetic cause.<h4>Methods</h4>A total of 335,115 DXA scans were screened to identify HBM index cases (defined by DXA scan as an L1 Z-score of ≥+3.2 and total hip Z-score ≥+1.2, or total hip Z-score ≥+3.2 and L1 Z- ...[more]

PMID: 23362220

Similar Datasets

Project description:High bone mass (HBM), detected in 0.2% of DXA scans, is characterised by a mild skeletal dysplasia largely unexplained by known genetic mutations. We conducted the first systematic assessment of the skeletal phenotype in unexplained HBM using pQCT in our unique HBM population identified from screening routine UK NHS DXA scans. pQCT measurements from the mid and distal tibia and radius in 98 HBM cases were compared with (i) 65 family controls (constituting unaffected relatives and spouses), and (ii) 692 general population controls. HBM cases had substantially greater trabecular density at the distal tibia (340 [320, 359] mg/cm(3)), compared to both family (294 [276, 312]) and population controls (290 [281, 299]) (p<0.001 for both, adjusted for age, gender, weight, height, alcohol, smoking, malignancy, menopause, steroid and estrogen replacement use). Similar results were obtained at the distal radius. Greater cortical bone mineral density (cBMD) was observed in HBM cases, both at the midtibia and radius (adjusted p<0.001). Total bone area (TBA) was higher in HBM cases, at the distal and mid tibia and radius (adjusted p<0.05 versus family controls), suggesting greater periosteal apposition. Cortical thickness was increased at the mid tibia and radius (adjusted p<0.001), implying reduced endosteal expansion. Together, these changes resulted in greater predicted cortical strength (strength strain index [SSI]) in both tibia and radius (p<0.001). We then examined relationships with age; tibial cBMD remained constant with increasing age amongst HBM cases (adjusted ? -0.01 [-0.02, 0.01], p=0.41), but declined in family controls (-0.05 [-0.03, -0.07], p<0.001) interaction p=0.002; age-related changes in tibial trabecular BMD, CBA and SSI were also divergent. In contrast, at the radius HBM cases and controls showed parallel age-related declines in cBMD and trabecular BMD. HBM is characterised by increased trabecular BMD and by alterations in cortical bone density and structure, leading to substantial increments in predicted cortical bone strength. In contrast to the radius, neither trabecular nor cortical BMD declined with age in the tibia of HBM cases, suggesting attenuation of age-related bone loss in weight-bearing limbs contributes to the observed bone phenotype.

Dataset Information

High bone mass is associated with an increased prevalence of joint replacement: a case-control study.

Objective

Methods

Results

Conclusion

Publications

High bone mass is associated with an increased prevalence of joint replacement: a case-control study.

Similar Datasets

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