Bone Microarchitecture Assessed by 3D High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) as predictor of fracture risk in patients with glucocorticoid-induced osteoporosis
Description: Objectives: To ascertain whether compromised bone quality and strength at baseline could predict incident fragility fracture in rheumatic disease (RD) patients on long-term glucocorticoid (LTGC) treatment
Hypothesis to be tested:
We hypothesize that baseline bone quality and strength rather than change in these parameters in RD patients on LTGC treatment could predict incident fragility fracture, independent of areal bone mineral density (aBMD).
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Design and subjects: 220 RD patients on LTGC (110 with vertebral fracture and 110 without vertebral fracture) who participated in a cross-sectional study in 2014-2015 with baseline 1) aBMD using dual-energy x-ray absorptiometry (DXA), 2) volumetric BMD (vBMD), microstructure and bone strength assessment of the wrist and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) and 3) spine radiographs, will be invited to have a 5th year follow-up assessment.
Interventions: All patients will have a repeat assessment with 1) aBMD and 2) HR-pQCT 3) spine radiographs.
Outcome measures:
Primary outcome
To compare the differences in bone quality (vBMD, bone microarchitecture) and strength at baseline in RD patients on LTGC with and without incident fragility fracture over a period of 5 years.
Secondary outcomes
1) To compare the differences in the change in bone quality and strength in patients with and without incident fragility fracture.
2) To ascertain whether bone quality and strength assessment is more sensitive than aBMD in predicting fragility fracture.
Expected results: Baseline bone quality and strength rather than change in these parameters can predict fracture risk independent of aBMD in RD patients on LTGC
Funder: Health and Medical Research Fund
Amount: HKD 1,185,000
Funding type: grant
Funder scheme: HMRF - Advanced Medical Research
Start date: 2017-01-01
Investigator: Lai-shan TAM
Institution: Department of Medicine and Therapeutics, The Chinese University of Hong Kong
Funded outputs count: 1
Funder award ID: 06170366
OpenAlex ID: G8260669674