Hip fractures are among the most common types of osteoporotic fractures that affect one in three women and one in six men over the age of 50 [1]. It is well known that loss of bone mass, quantified by bone mineral density using Dual-energy X-ray Absorptiometry (DXA), is associated with the increasing risk of bone fractures. However, bone mineral density (BMD) alone cannot fully explain changes in fracture risks [2, 3]. In particular, BMD is not able to predict fracture risks for women with osteopenia, in which a BMD T-score is between −1.0 and −2.5. This suggests additional factors (i.e., bone quality) should be considered in predicting fracture risks [4].

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