BACKGROUND: There is increasing evidence that correct interpretation of bone mineral density (BMD) measurements by dual energy X-ray absorptiometry (DEXA) requires a population-specific reference range. We therefore collected data on age-related BMD in a random sample of the normal adult Austrian population to establish an appropriate normative database. METHODS: We measured BMD by DEXA at five different skeletal sites in 1089 subjects, i.e. 654 females and 435 males, aged between 21-76 years, who had been recruited by 17 centres across Austria. RESULTS: Age-related bone loss was observed until age 65 years with significant changes at the lumbar spine (r = -0.23), total hip (r = -0.07), trochanter (r = -0.10), femoral neck (r = -0.30) and Ward's triangle (r = -0.40) in the women but only at the femoral neck (r = -0.23) and at Ward's triangle (r = -0.40) in the men. When we calculated T scores from the BMD data of the young normal adult study population and used the T score set points according to the WHO classification of osteopenia and osteoporosis, we found that, depending on the skeletal site measured, 7.6-27.4% of the women and 16-41% of the men in our study group had low bone mass, whereas 0.6-2.7% of the female and 0.2-1.0% of the male study population were osteoporotic. However, osteoporosis was indicated in 4-9-fold more females and 5-15-fold more males when we based our estimates on the normative data provided by the manufacturers of the DEXA systems. CONCLUSION: Our data underscore the importance of using a population-specific reference range for DEXA measurements to avoid overdiagnosis of osteoporosis.
BACKGROUND: There is increasing evidence that correct interpretation of bone mineral density (BMD) measurements by dual energy X-ray absorptiometry (DEXA) requires a population-specific reference range. We therefore collected data on age-related BMD in a random sample of the normal adult Austrian population to establish an appropriate normative database. METHODS: We measured BMD by DEXA at five different skeletal sites in 1089 subjects, i.e. 654 females and 435 males, aged between 21-76 years, who had been recruited by 17 centres across Austria. RESULTS: Age-related bone loss was observed until age 65 years with significant changes at the lumbar spine (r = -0.23), total hip (r = -0.07), trochanter (r = -0.10), femoral neck (r = -0.30) and Ward's triangle (r = -0.40) in the women but only at the femoral neck (r = -0.23) and at Ward's triangle (r = -0.40) in the men. When we calculated T scores from the BMD data of the young normal adult study population and used the T score set points according to the WHO classification of osteopenia and osteoporosis, we found that, depending on the skeletal site measured, 7.6-27.4% of the women and 16-41% of the men in our study group had low bone mass, whereas 0.6-2.7% of the female and 0.2-1.0% of the male study population were osteoporotic. However, osteoporosis was indicated in 4-9-fold more females and 5-15-fold more males when we based our estimates on the normative data provided by the manufacturers of the DEXA systems. CONCLUSION: Our data underscore the importance of using a population-specific reference range for DEXA measurements to avoid overdiagnosis of osteoporosis.
Authors: M Salleh M Ardawi; Abdulraouf A Maimany; Talal M Bahksh; Hasan A N Nasrat; Waleed A Milaat; Raja M Al-Raddadi Journal: Osteoporos Int Date: 2004-05-27 Impact factor: 4.507
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Authors: Stuart H Ralston; André G Uitterlinden; Maria Luisa Brandi; Susana Balcells; Bente L Langdahl; Paul Lips; Roman Lorenc; Barbara Obermayer-Pietsch; Serena Scollen; Mariona Bustamante; Lise Bjerre Husted; Alisoun H Carey; Adolfo Diez-Perez; Alison M Dunning; Alberto Falchetti; Elzbieta Karczmarewicz; Marcin Kruk; Johannes P T M van Leeuwen; Joyce B J van Meurs; Jon Mangion; Fiona E A McGuigan; Leonardo Mellibovsky; Francesca del Monte; Huibert A P Pols; Jonathan Reeve; David M Reid; Wilfried Renner; Fernando Rivadeneira; Natasja M van Schoor; Rachael E Sherlock; John P A Ioannidis Journal: PLoS Med Date: 2006-02-21 Impact factor: 11.069