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

Abstract

Objectives To examine the extent to which geometric parameters derived from dual-energy x-ray absorptiometry (DXA) scans in the UK Biobank (UKB) study are related to hip osteoarthritis (HOA) independently of sex, age and body size. Methods Femoral neck width (FNW), diameter of the femoral head (DFH) and hip axis length (HAL) were derived automatically from left hip DXA scans in UKB 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 hip osteoarthritis (rHOA) and 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 Complete data were available for 40,312 participants. In age and sex-adjusted analyses, FNW, HAL and DFH were all related to increased risk of rHOA. Despite strong relationships between geometric parameters and body size, relationships between geometric parameters and HOA showed little attenuation after adjustment for height and weight. Following mutual adjustment, both HAL and FNW retained independent relationships with rHOA, while DFH was now protective. Only FNW was independently related to HESOA and THR. Conclusion Greater FNW and HAL were independently related to an increased risk of rHOA, whereas greater DFH appeared to be protective. Greater FNW was independently predictive of HESOA and THR. These results suggest DXA-derived geometric parameters, particularly FNW, could help to predict HOA and THR risk.

Competing Interest Statement

TC & CL have a patent image processing apparatus and method for fitting a deformable shape model to an image using random forest regression voting. This is licensed with royalties to Optasia Medical. NH reports consultancy fees and honoraria from UCB, Amgen, Kyowa Kirin, Thornton Ross, Consilient.

Funding Statement

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. 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.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

UK Biobank has ethical approval from the National Information Governance Board for Health and Social Care and North-West Multi-centre Research Ethics Committee (11/NW/0382) which covers this study (application number 17295). All participants gave informed written consent.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All geometric parameters included in this study have been returned to UK Biobank and will be available at a forthcoming data release. Users must be registered with UK Biobank to access their resources [https://bbams.ndph.ox.ac.uk/ams/].

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