Relationships between metacarpal morphometry, forearm and vertebral bone density and fractures in post-menopausal...

The relationships between metacarpal morphometric, vertebral and forearm density measurements and the prevalence of vertebral and peripheral fractures were examined in 239 postmenopausal women (median age 63, range 32-84 years). Metacarpal cortical area/total area ratio (CA/TA) was measured with needle calipers, forearm mineral density (FMD) by single photon absorptiometry and vertebral mineral density (VMD) by single energy quantitative computed tomography. Of the 239 subjects 97 had not suffered any fractures, 44 had at least one previous vertebral fracture but no peripheral fractures, 41 had a history of peripheral fracture but no vertebral fracture and 57 had suffered both peripheral and vertebral fractures. There were significant correlations between a single 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 had suffered fractures, when compared with the no fracture group. The percentage of cases in each of the four fracture groups (vertebral fracture 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. We suggest that metacarpal morphometry, which is widely available at relatively low cost, yields cross-sectional information about bone density and fracture risk, comparable with that obtained by forearm and vertebral densitometry.