@article{3053536,
    title = "Hip geometry, bone mineral distribution, and bone strength in European
men and women: the EPOS Study",
    author = "Crabtree, N and Lunt, M and Holt, G and Kroger, H and Burger, H and and Grazio, S and Khaw, KT and Lorenc, RS and Nijs, J and Stepan, J and and Falch, JA and Miazgowski, T and Raptou, P and Pols, HAP and Dequeker, J and and Havelka, S and Hoszowski, K and Jajic, I and Czekalski, S and and Lyritis, G and Silman, AJ and Reeve, J",
    journal = "Bone",
    year = "2000",
    volume = "27",
    number = "1",
    pages = "151-159",
    publisher = "EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC",
    issn = "8756-3282",
    doi = "10.1016/S8756-3282(00)00300-8",
    keywords = "osteoporosis; hip fracture; bone mineral density; hip strength;
epidemiology; biomechanics",
    abstract = "Hip geometry and bone mineral density (BMD) have been shown previously
to relate, independently of each other, to risk of hip fracture. We used
Lunar DPX “beta” versions of hip strength analysis (HSA) and hip
axis length (HAL) software to analyze scans from ten representative
age-stratified population samples in the European Prospective
Osteoporosis Study (EPOS), All 1617 subjects were >50 years of age, and
1033 were women. The data were modeled with gender and center as
categorical variables. The bone mineral density of the upper half of the
femoral neck declined at a faster rate with age than that in the lower
half, Femoral neck cross-sectional moment of inertia (CSMI), a measure
of resistance to bending, showed no significant age reduction in either
gender. However,height and weight effects on CSMI were significantly
more beneficial in men than in women (0.002 < p < 0.012) and the weight
effect appeared to be mediated by bone mineral content (BMC),
Compressive stress (Cstress), defined as the stress in the femoral neck
at its weakest cross section arising from a standardized fall, was
higher in women. Although Cstress increased with body weight when BMC
was held constant, in practice it fell through the association and
statistical interaction of rising body weight with rising BMC, HAL, as
expected, was strongly positively associated with male gender and also
height (p < 0.0001). Hip strength-related indices were markedly
center-dependent. Significant differences (p < 0.0001) were noted
between the centers for all the variables investigated that related to
hip geometry. Adjustment for femoral neck bone mineral content (totBMC)
showed these center differences to account for >50% of center variation
in hip strength, which remained highly significant (p < 0.0001). We
conclude that there are substantial geographical differences in femoral
neck geometry as well as in BMD, These geometric variations may
contribute to the large variations in hip fracture risk across Europe.
The effects of aging on hip strength need to be explored in longitudinal
studies. (Bone 27:151-159; 2000) (C) 2000 by Elsevier Science Inc. All
rights reserved."
}