Hip geometric parameters are associated with radiographic and clinical hip osteoarthritis: Findings from a cross-sectional study in UK Biobank

Sophie Heppenstall; Raja Ebsim; Fiona R Saunders; Claudia Lindner; Jenny Gregory; Richard M Aspden; Nicholas C Harvey; Timothy Cootes; Jonathan H Tobias; Monika R Frysz; Ben G Faber

doi:10.1016/j.joca.2023.09.001

Hip geometric parameters are associated with radiographic and clinical hip osteoarthritis: Findings from a cross-sectional study in UK Biobank

Sophie Heppenstall
, Raja Ebsim
, Fiona R Saunders
, Claudia Lindner
, Jenny Gregory
, Richard M Aspden
, Nicholas C Harvey
, Timothy Cootes
, Jonathan H Tobias
, Monika R Frysz
, Ben G Faber^*

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

10 Citations (Scopus)

Abstract

Objective
To examine the extent to which geometric parameters derived from dual-energy x-ray absorptiometry (DXA) scans in the UK Biobank study are related to hip osteoarthritis (HOA) independently of sex, age and body size.

Design
Femoral neck width (FNW), diameter of the femoral head (DFH) and hip axis length (HAL) were derived automatically from left hip DXA scans in UK Biobank using outline points placed around the hip by a machine-learning program. Correlations were calculated between geometric parameters, age, height, and weight. Logistic regression was used to examine the relationship of geometric parameters with radiographic HOA, hospital diagnosed HOA (HESOA), and Cox proportional hazards model to evaluate the relationship with total hip replacement (THR). Analyses were adjusted for sex, age, height, weight, and geometric parameters.

Results
The study consisted of 40,312 participants. In age and sex-adjusted analyses, FNW, HAL and DFH were related to increased risk of radiographic HOA. In a model adjusted for age, sex, height, weight and other geometric parameters, both FNW and HAL retained independent relationships with radiographic HOA [FNW: odds ratios 2.38 (2.18–2.59), HAL: 1.25 (1.15–1.36)], while DFH was now protective [0.55 (0.50–0.61)]. Only FNW was independently related to HESOA [2.20 (1.80–2.68)] and THR [hazard ratios 2.51 (1.89–3.32)].

Conclusion
Greater FNW and HAL were independently related to an increased risk of radiographic HOA, whereas greater DFH appeared to be protective. Greater FNW was independently associated with HESOA and THR. These results suggest that DXA-derived geometric parameters, particularly FNW, could help determine HOA and THR risk.

Original language	English
Pages (from-to)	1627-1635
Number of pages	9
Journal	Osteoarthritis and Cartilage
Volume	31
Issue number	12
Early online date	11 Sept 2023
DOIs	https://doi.org/10.1016/j.joca.2023.09.001
Publication status	E-pub ahead of print - 11 Sept 2023

Bibliographical note

Funding Information:
CL was funded by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society ( 223267/Z/21/Z ). NCH acknowledges support from the MRC and NIHR Southampton Biomedical Research Centre , University of Southampton and University Hospital Southampton . BGF, MF & JHT work in the MRC Integrative Epidemiology Unit at the University of Bristol, which is supported by the MRC ( MC_UU_00011/1 ). BGF is a National Institute for Health and Care Research Academic Clinical Lecturer and was previously supported by a Medical Research Council (MRC) clinical research training fellowship (MR/S021280/1). No funders had any role in the study design, collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

Funding Information:
SVH was a self-funded undergraduate student for this work. RE, MF, FS are supported, and this work is funded by a Wellcome Trust collaborative award (reference number 209233). This research was funded in whole, or in part, by the Wellcome Trust [Grant number 223267/Z/21/Z ]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

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© 2023 The Authors

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Heppenstall, S., Ebsim, R., Saunders, F. R., Lindner, C., Gregory, J., Aspden, R. M., Harvey, N. C., Cootes, T., Tobias, J. H., Frysz, M. R., & Faber, B. G. (2023). Hip geometric parameters are associated with radiographic and clinical hip osteoarthritis: Findings from a cross-sectional study in UK Biobank. Osteoarthritis and Cartilage, 31(12), 1627-1635. Advance online publication. https://doi.org/10.1016/j.joca.2023.09.001

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title = "Hip geometric parameters are associated with radiographic and clinical hip osteoarthritis: Findings from a cross-sectional study in UK Biobank",

abstract = "Objective To examine the extent to which geometric parameters derived from dual-energy x-ray absorptiometry (DXA) scans in the UK Biobank study are related to hip osteoarthritis (HOA) independently of sex, age and body size. Design Femoral neck width (FNW), diameter of the femoral head (DFH) and hip axis length (HAL) were derived automatically from left hip DXA scans in UK Biobank using outline points placed around the hip by a machine-learning program. Correlations were calculated between geometric parameters, age, height, and weight. Logistic regression was used to examine the relationship of geometric parameters with radiographic HOA, hospital diagnosed HOA (HESOA), and Cox proportional hazards model to evaluate the relationship with total hip replacement (THR). Analyses were adjusted for sex, age, height, weight, and geometric parameters. Results The study consisted of 40,312 participants. In age and sex-adjusted analyses, FNW, HAL and DFH were related to increased risk of radiographic HOA. In a model adjusted for age, sex, height, weight and other geometric parameters, both FNW and HAL retained independent relationships with radiographic HOA [FNW: odds ratios 2.38 (2.18–2.59), HAL: 1.25 (1.15–1.36)], while DFH was now protective [0.55 (0.50–0.61)]. Only FNW was independently related to HESOA [2.20 (1.80–2.68)] and THR [hazard ratios 2.51 (1.89–3.32)]. Conclusion Greater FNW and HAL were independently related to an increased risk of radiographic HOA, whereas greater DFH appeared to be protective. Greater FNW was independently associated with HESOA and THR. These results suggest that DXA-derived geometric parameters, particularly FNW, could help determine HOA and THR risk. ",

author = "Sophie Heppenstall and Raja Ebsim and Saunders, \{Fiona R\} and Claudia Lindner and Jenny Gregory and Aspden, \{Richard M\} and Harvey, \{Nicholas C\} and Timothy Cootes and Tobias, \{Jonathan H\} and Frysz, \{Monika R\} and Faber, \{Ben G\}",

note = "Funding Information: CL was funded by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society ( 223267/Z/21/Z ). NCH acknowledges support from the MRC and NIHR Southampton Biomedical Research Centre , University of Southampton and University Hospital Southampton . BGF, MF \& JHT work in the MRC Integrative Epidemiology Unit at the University of Bristol, which is supported by the MRC ( MC\_UU\_00011/1 ). BGF is a National Institute for Health and Care Research Academic Clinical Lecturer and was previously supported by a Medical Research Council (MRC) clinical research training fellowship (MR/S021280/1). No funders had any role in the study design, collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. Funding Information: SVH was a self-funded undergraduate student for this work. RE, MF, FS are supported, and this work is funded by a Wellcome Trust collaborative award (reference number 209233). This research was funded in whole, or in part, by the Wellcome Trust [Grant number 223267/Z/21/Z ]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = sep,

day = "11",

doi = "10.1016/j.joca.2023.09.001",

language = "English",

volume = "31",

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}

Heppenstall, S, Ebsim, R, Saunders, FR, Lindner, C, Gregory, J, Aspden, RM, Harvey, NC, Cootes, T, Tobias, JH, Frysz, MR & Faber, BG 2023, 'Hip geometric parameters are associated with radiographic and clinical hip osteoarthritis: Findings from a cross-sectional study in UK Biobank', Osteoarthritis and Cartilage, vol. 31, no. 12, pp. 1627-1635. https://doi.org/10.1016/j.joca.2023.09.001

TY - JOUR

T1 - Hip geometric parameters are associated with radiographic and clinical hip osteoarthritis

T2 - Findings from a cross-sectional study in UK Biobank

AU - Heppenstall, Sophie

AU - Ebsim, Raja

AU - Saunders, Fiona R

AU - Lindner, Claudia

AU - Gregory, Jenny

AU - Aspden, Richard M

AU - Harvey, Nicholas C

AU - Cootes, Timothy

AU - Tobias, Jonathan H

AU - Frysz, Monika R

AU - Faber, Ben G

N1 - Funding Information: CL was funded by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society ( 223267/Z/21/Z ). NCH acknowledges support from the MRC and NIHR Southampton Biomedical Research Centre , University of Southampton and University Hospital Southampton . BGF, MF & JHT work in the MRC Integrative Epidemiology Unit at the University of Bristol, which is supported by the MRC ( MC_UU_00011/1 ). BGF is a National Institute for Health and Care Research Academic Clinical Lecturer and was previously supported by a Medical Research Council (MRC) clinical research training fellowship (MR/S021280/1). No funders had any role in the study design, collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication. Funding Information: SVH was a self-funded undergraduate student for this work. RE, MF, FS are supported, and this work is funded by a Wellcome Trust collaborative award (reference number 209233). This research was funded in whole, or in part, by the Wellcome Trust [Grant number 223267/Z/21/Z ]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © 2023 The Authors

PY - 2023/9/11

Y1 - 2023/9/11

N2 - Objective To examine the extent to which geometric parameters derived from dual-energy x-ray absorptiometry (DXA) scans in the UK Biobank study are related to hip osteoarthritis (HOA) independently of sex, age and body size. Design Femoral neck width (FNW), diameter of the femoral head (DFH) and hip axis length (HAL) were derived automatically from left hip DXA scans in UK Biobank using outline points placed around the hip by a machine-learning program. Correlations were calculated between geometric parameters, age, height, and weight. Logistic regression was used to examine the relationship of geometric parameters with radiographic HOA, hospital diagnosed HOA (HESOA), and Cox proportional hazards model to evaluate the relationship with total hip replacement (THR). Analyses were adjusted for sex, age, height, weight, and geometric parameters. Results The study consisted of 40,312 participants. In age and sex-adjusted analyses, FNW, HAL and DFH were related to increased risk of radiographic HOA. In a model adjusted for age, sex, height, weight and other geometric parameters, both FNW and HAL retained independent relationships with radiographic HOA [FNW: odds ratios 2.38 (2.18–2.59), HAL: 1.25 (1.15–1.36)], while DFH was now protective [0.55 (0.50–0.61)]. Only FNW was independently related to HESOA [2.20 (1.80–2.68)] and THR [hazard ratios 2.51 (1.89–3.32)]. Conclusion Greater FNW and HAL were independently related to an increased risk of radiographic HOA, whereas greater DFH appeared to be protective. Greater FNW was independently associated with HESOA and THR. These results suggest that DXA-derived geometric parameters, particularly FNW, could help determine HOA and THR risk.

AB - Objective To examine the extent to which geometric parameters derived from dual-energy x-ray absorptiometry (DXA) scans in the UK Biobank study are related to hip osteoarthritis (HOA) independently of sex, age and body size. Design Femoral neck width (FNW), diameter of the femoral head (DFH) and hip axis length (HAL) were derived automatically from left hip DXA scans in UK Biobank using outline points placed around the hip by a machine-learning program. Correlations were calculated between geometric parameters, age, height, and weight. Logistic regression was used to examine the relationship of geometric parameters with radiographic HOA, hospital diagnosed HOA (HESOA), and Cox proportional hazards model to evaluate the relationship with total hip replacement (THR). Analyses were adjusted for sex, age, height, weight, and geometric parameters. Results The study consisted of 40,312 participants. In age and sex-adjusted analyses, FNW, HAL and DFH were related to increased risk of radiographic HOA. In a model adjusted for age, sex, height, weight and other geometric parameters, both FNW and HAL retained independent relationships with radiographic HOA [FNW: odds ratios 2.38 (2.18–2.59), HAL: 1.25 (1.15–1.36)], while DFH was now protective [0.55 (0.50–0.61)]. Only FNW was independently related to HESOA [2.20 (1.80–2.68)] and THR [hazard ratios 2.51 (1.89–3.32)]. Conclusion Greater FNW and HAL were independently related to an increased risk of radiographic HOA, whereas greater DFH appeared to be protective. Greater FNW was independently associated with HESOA and THR. These results suggest that DXA-derived geometric parameters, particularly FNW, could help determine HOA and THR risk.

U2 - 10.1016/j.joca.2023.09.001

DO - 10.1016/j.joca.2023.09.001

M3 - Article (Academic Journal)

C2 - 37704099

SN - 1063-4584

VL - 31

SP - 1627

EP - 1635

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

IS - 12

ER -

Hip geometric parameters are associated with radiographic and clinical hip osteoarthritis: Findings from a cross-sectional study in UK Biobank

Abstract

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