An Updated Reference for Calculating Bone Mineral Density T-Scores

2021 ◽  
Author(s):  
Shanshan Xue ◽  
Yuzheng Zhang ◽  
Wenjing Qiao ◽  
Qianqian Zhao ◽  
Dingjie Guo ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mass ◽  
Bone Mineral ◽  
Low Bone Mass ◽  
Mineral Density ◽  
Opposite Pattern ◽  
T Score ◽  
Peak Bmd

Abstract Context Bone mineral density (BMD) T-score reference may be updated when the peak BMD of the population is unclear and may need to be updated. Objective To update BMD T-score references using the peak BMD from the most recent National Health and Nutrition Examination Survey (NHANES) data. Design Cross-sectional study. Setting The NHANES 2005-2014. Participants Non-Hispanic white females between the ages 10-40 years (N=1549) were our target population to estimate peak BMD (SD). Individuals aged≥50 years (N=5523) were used to compare the percentages of osteoporosis and low bone mass based on existing and updated BMD T-score references. Main Outcome Measurements: BMD data within the age at attainment of peak BMD±5 years were used to calculate updated BMD T-score references. Results The updated average of BMD (SD) for diagnosing osteoporosis at the femoral neck and lumbar spine were 0.888 g/cm 2 (0.121 g/cm 2) and 1.065 g/cm 2 (0.122 g/cm 2), respectively. The percentages of individuals with osteoporosis at the femoral neck and low bone mass at the femoral neck and lumbar spine based on the updated BMD T-score references were higher than the percentages of people designated with these outcomes under the existing guidelines (P<0.001). However, we observed the opposite pattern for lumbar spine osteoporosis (P<0.001). Conclusions We calculated new BMD T-score references at the femoral neck and lumbar spine. We found significant differences in the percentages of individuals classified as having osteoporosis and low bone mass between the updated and existing BMD T-score references.

scholarly journals The Recent Prevalence of Osteoporosis and Low Bone Mass in the United States Based on Bone Mineral Density at the Femoral Neck or Lumbar Spine

2014 ◽  
Vol 29 (11) ◽  
pp. 2520-2526 ◽  
Author(s):  
Nicole C Wright ◽  
Anne C Looker ◽  
Kenneth G Saag ◽  
Jeffrey R Curtis ◽  
Elizabeth S Delzell ◽  
...  
Keyword(s):  
United States ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mass ◽  
Bone Mineral ◽  
The United States ◽  
Low Bone Mass ◽  
Mineral Density ◽  
Prevalence Of Osteoporosis

scholarly journals Genome Screen for QTLs Contributing to Normal Variation in Bone Mineral Density and Osteoporosis*

2000 ◽  
Vol 85 (9) ◽  
pp. 3116-3120 ◽  
Author(s):  
D. L. Koller ◽  
M. J. Econs ◽  
P. A. Morin ◽  
J. C. Christian ◽  
S. L. Hui ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Lod Score ◽  
Genome Screen ◽  
Sibling Pairs ◽  
Peak Bmd ◽  
Chromosome 1Q21

Abstract A major determinant of the risk for osteoporosis is peak bone mineral density (BMD), which is largely determined by genetic factors. We recently reported linkage of peak BMD in a large sample of healthy sister pairs to chromosome 11q12–13. To identify additional loci underlying normal variations in peak BMD, we conducted an autosomal genome screen in 429 Caucasian sister pairs. Multipoint LOD scores were computed for BMD at four skeletal sites. Chromosomal regions with LOD scores above 1.85 were further pursued in an expanded sample of 595 sister pairs (464 Caucasians and 131 African-Americans). The highest LOD score attained in the expanded sample was 3.86 at chromosome 1q21–23 with lumbar spine BMD. Chromosome 5q33–35 gave a LOD score of 2.23 with femoral neck BMD. At chromosome 6p11–12, the 464 Caucasian pairs achieved a LOD score of 2.13 with lumbar spine BMD. Markers within the 11q12–13 region continued to support linkage to femoral neck BMD, although the peak LOD score was decreased to 2.16 in the sample of 595 sibling pairs. Our study is the largest genome screen to date for genes underlying variations in peak BMD and represents an important step toward identifying genes contributing to osteoporosis in the general population.

scholarly journals POS1106 FRAX AND THE EFFECT OF TERIPARATIDE ON BONE MINERAL DENSITY IN SECONDARY OSTEOPOROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 833.2-834
Author(s):  
S. Garcia ◽  
B. M. Fernandes ◽  
M. Rato ◽  
F. Oliveira Pinheiro ◽  
D. Fonseca ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Hip Fracture ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Fracture Probability ◽  
Mineral Density ◽  
T Score

Background:Teriparatide has been shown to increase spine and hip bone mineral density (BMD) and to reduce vertebral and non-vertebral fractures. (1) It is currently not clear whether the effect of teriparatide is dependent on the baseline risk of fracture or osteoporosis (OP) type, a finding that could have an impact on our therapeutic decision.Objectives:Investigate if there is a relationship between teriparatide effect in BMD and baseline 10-year fracture probability, assessed using FRAX®, in primary and secondary OP patients.Methods:This is a longitudinal, retrospective study including consecutive patients with the diagnosis of OP treated with teriparatide for 24 months, with a ten-year follow-up period, at our rheumatology department. Demographic, clinical, laboratorial, BMD and occurrence of fracture data were collected. The 10-year risk of osteoporotic fracture was estimated using the fracture risk assessment tool (FRAX) v 4.1 with the Portuguese population reference. Statistical analysis was performed using the software SPSS 23.0. Correlations between continuous variables were evaluated with spearman coefficient. p<0.05 was considered statistically significant.Results:Eighty patients (88.8% female, median age 65.00 (59; 75)) were included. Forty-nine patients (61.3%) has secondary OP, mainly of cortisonic etiology (61.2%, n=30). Before treatment, median lumbar spine BMD was 0.870 [0.767, 0.964] g/cm2, median T-score of -2.60 (-3.30, -1.90); median total femur BMD was 0.742 [0.667, 0.863] g/cm2, median T-score of -2.10 (-2.80, -1.30); median femoral neck BMD was 0.671 [0.611, 0.787] g/cm2, median T-score of -2.50 [-3.20, -1.85]. Regarding fracture risk, median FRAX-based 10-year major fracture risk (with BMD) at baseline was 16% [10.0; 23], and median hip fracture risk was 7.2% [3.4; 13.8].The median variation of BMD, after finishing teriparatide treatment, in the spine was 0.107 [0.029; 0.228]; median BMD variation in total femur was 0.013 [-0.013; 0.068] and median BMD femoral neck was 0.046 [-0.002; 0.109]. We observed a numerically superior effect, albeit without any statistical significance, of teriparatide on bone mineral density gain in secondary OP (versus primary OP) at lumbar spine, total femur and femoral neck.Most patients continued anti-osteoporotic treatment with a bisphosphonate (81.2%, n=65) and, during follow-up, 17 patients had an incident fracture (8 hip fractures and 6 vertebral fractures), median of 5 [1.75, 8.25] years after ending teriparatide.We found a discrete correlation between FRAX-based hip fracture probability and the variation of bone mineral density in total femur (Spearman’s coefficient 0.248, p = 0.04). There was no correlation between FRAX-based major fracture probability and and the variation of bone mineral density in the spine or femur. When we separately analyze the relationship between the variation in total hip BMD and the FRAX-based fracture risk, depending on whether it is a secondary or primary OP, we find that the correlation is stronger and only remains in secondary OP (Spearman’s coefficient 0.348, p = 0.03).Conclusion:Our data suggest that teriparatide could be an important weapon in the treatment of secondary cause OP, particularly cortisonic, and in patients at high fracture risk, although further larger studies are needed to confirm these findings.References:[1]Kendler DL, Marin F, Zerbini CAF, Russo LA, Greenspan SL, Zikan V, Bagur A, Malouf-Sierra J, Lakatos P, Fahrleitner-Pammer A, Lespessailles E, Minisola S, Body JJ, Geusens P, Möricke R, López-Romero P. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet. 2018 Jan 20;391(10117):230-240. doi: 10.1016/S0140-6736(17)32137-2.Disclosure of Interests:None declared.

Investigation of the Effect of Bone Mineral Density on the Postoperative Outcome of Ankle Fractures in Elderly Patients

2021 ◽  
pp. 107110072199626
Author(s):  
Young Hwan Park ◽  
Hyun Woo Cho ◽  
Jung Woo Choi ◽  
Hak Jun Kim
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Outcome Measures ◽  
Bone Mineral ◽  
Postoperative Outcome ◽  
Ankle Fractures ◽  
Mineral Density ◽  
T Score

Background: The association between ankle fractures in elderly patients and low bone mineral density (BMD) has recently been recognized, but the effect of BMD on the postoperative outcome of these fractures is unknown. The aim of this study was to investigate the effect of BMD on the postoperative outcome of ankle fractures in elderly patients to evaluate the need for BMD screening. Methods: We retrospectively reviewed 48 patients aged 65 years or older who had ankle fractures and underwent dual-energy x-ray absorptiometry to assess BMD after surgical treatment of the fracture. Postoperative outcomes were assessed using the Olerud-Molander Ankle Score (OMAS), visual analog scale (VAS) score for pain, Kellgren and Lawrence (K&L) grading scale score, and quality of fracture reduction. The correlation between the BMD and the outcome measures at 12 months after surgery was analyzed using the Pearson correlation coefficient. Results: The mean absolute value of BMD was 0.6 ± 0.1 g/cm2 (T-score, –1.5 ± 1.2) at the femoral neck and 0.8 ± 0.2 g/cm2 (T-score, –1.2 ± 1.5) at the lumbar spine. Osteoporosis was present in 33% of female patients and in 11% of male patients. At 12 months after surgery, the OMAS was 70 ± 17 and the VAS score for pain was 18 ± 17. Of the patients, 20, 21, 5, 1, and 1 had K&L grades of 0, 1, 2, 3, and 4, respectively. None of the clinical and radiographic outcome measures were correlated with the BMD values of the patients. Conclusion: The postoperative outcome of the ankle fractures in elderly patients at 12 months after surgery showed no correlation with femoral neck or lumbar spine BMD at the time of fracture. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Evaluation of the Discrepancy in Bone Mineral Density Between the Lumbar Spine and Femoral Neck Among Japanese Women According to Age

2020 ◽  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Significant Contribution ◽  
Japanese Women ◽  
Mineral Density ◽  
T Score ◽  
Fracture History ◽  
Different Characteristics

This study aimed to examine the age-specific individual discrepancy between lumbar spine (LS) bone mineral density (BMD) and femoral neck (FN) BMD in Japanese women and to compare the significantly different characteristics between the two bone sites. We found a higher prevalence rate of discordance between the two BMD T-score sites, and many patients had a lower LS BMD T-score than FN BMD T-score. We believe that our study makes a significant contribution to the literature because our findings suggest that physicians should assess BMD more carefully in women who have a low body weight or body mass index and parental hip fracture history. For these patients, it is necessary to measure both the LS and FN BMD T-scores for calculating the fracture risk.

Bone Mineral Density Changes In Patients with Paraproteinemia After Treatment with Bortezomib

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4989-4989
Author(s):  
Tamara Berno ◽  
Kenneth Boucher ◽  
Fenghuang Zhan ◽  
Guido J. Tricot ◽  
Benjamin Mughal ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Disease ◽  
Proteasome Inhibitor ◽  
Mineral Density ◽  
T Score ◽  
The Mean

Abstract Abstract 4989 Background: Bone disease is present at diagnosis in almost all patients with multiple myeloma (MM) and can impact substantially on patient morbidity and quality of life. Decreased bone mineral density is also observed not only in MM but also in patients with monoclonal gammopathy of undetermined significance (MGUS). The pathogenesis of bone disease in MM is complex. The activity of proteasome inhibitor bortezomib has been linked to increased bone formation and osteoblastic activation. Evidence from the available clinical data indicates that bortezomib has a positive impact on bone health in MM and demonstrates a bone anabolic effect. Methods: We analyzed retrospectively 53 patients with MM and 16 with MGUS who have completed bone density at least at diagnosis. 21 patients have completed two bone density (3 MGUS and 18 MM). The bone density was obtained in all patients at baseline and in 16 patients repeated after bortezomib treatement with a median time of bortezomib exposure of 6 months. We analyzed T-score values at lumbar spine and at femoral neck. Results: With a median age of 66 years, 41 male and 28 female were analyzed. At baseline the mean lumbar spine T-score of all subjects and of 16 MM treated with bortezomib was -0.50 and -0.76 respectively. At baseline the mean femoral neck T-score for all subjects and for 16 MM treated with Bortezomib was -1.56 and -1.31 respectively. The baseline mean lumbar spine T-score for MGUS and MM was -0.71 and -0.43 respectively. The baseline mean femoral neck T-score of MGUS and MM was -1.61 and -1.54 respectively. In the group of 16 patients treated with Bortezomib we observed from baseline a change in lumbar bone mineral density T-score of 0.36 and at femoral neck bone density T-score of 0.25. Conclusion: These data show that patients treated with proteasome inhibitor showed moderate increment in bone mineral density at lumbar spine and at femoral neck. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Bone Mineral Recovery after Parathyroidectomy in Patients with Primary and Renal Hyperparathyroidism

1998 ◽  
Vol 83 (11) ◽  
pp. 3845-3851 ◽  
Author(s):  
Mohamed Abdelhadi ◽  
Jörgen Nordenström
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Renal Transplant ◽  
Bone Density ◽  
Femoral Neck ◽  
Bone Mass ◽  
Distal Radius ◽  
Bone Mineral ◽  
Mineral Density ◽  
Total Body

Patients with hyperparathyroidism (HPT) generally display reduced bone mass due to excessive PTH activity. The effect of parathyroidectomy on bone mass changes in different types of HPT, however, is not well understood. Bone mineral density (BMD) was measured in the distal radius, total body, femoral neck, and lumbar spine by dual energy x-ray absorptiometry in four groups of patients with different hyperparathyroid conditions: primary symptomatic HPT (n = 54), primary asymptomatic (mild) HPT (n = 24), HPT associated with hemodialysis (n = 20), and HPT associated with renal transplant (n = 30). Subsets of patients with primary symptomatic HPT (n= 52), HPT associated with hemodialysis (n = 19), and HPT associated with renal transplant (n = 15) underwent parathyroidectomy, and bone density was measured longitudinally for 3 yr. Patients with primary asymptomatic (mild) HPT did not undergo surgery and were followed prospectively. Before surgery, all groups showed a greater reduction of bone mineral density in cortical bone (distal radius) than in predominantly trabecular bone (lumbar spine). In primary symptomatic HPT, the BMD z-score of the distal radius was −1.80 ± 0.21 (±sem), and the corresponding figures for the total body, femoral neck, and lumbar spine were −0.60 ± 0.15, −0.54 ± 0.14, and −0.53 ± 0.18 compared with those of an age- and sex-matched reference group. In renal HPT BMD z-scores were −2.51± 0.38 (hemodialysis patients) and −2.83 ± 0.43 (renal transplant patients) for the distal radius and between −0.81 and− 1.46 for the other measured sites. After parathyroidectomy, BMD increased by 1–8% at all sites in patients with primary symptomatic HPT and HPT associated with renal transplant. The largest increase in bone mass was observed in patients with HPT associated with hemodialysis, in whom the improvement amounted to 7–23%. In patients with primary HPT and HPT associated with hemodialysis, this increase in bone density resulted in virtual recovery from their preoperative bone loss. The majority of patients with asymptomatic primary HPT disease (n = 21) maintained their bone density during the follow-up period and have not shown evidence of increases in serum calcium or PTH levels, but three patients followed conservatively underwent parathyroidectomy due to progressive deterioration of BMD. We conclude that, regardless of the etiology, a large proportion of HPT patients show reduced bone density. In patients with primary symptomatic HPT and patients with HPT associated with hemodialysis, bone density increases after parathyroidectomy to an extent that largely restores the preoperative bone loss. However, no anabolic effect of parathyroidectomy on bone mass was observed in patients with HPT associated with renal transplant, probably because of their immunosuppressive therapy.

scholarly journals Effects of alendronate on bone mass in women with osteoporosis

2006 ◽  
Vol 59 (9-10) ◽  
pp. 427-435
Author(s):  
Nada Pilipovic ◽  
Slobodan Brankovic ◽  
Nada Vujasinovic-Stupar
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Bone Mineral ◽  
Mineral Density ◽  
Control Groups ◽  
T Score ◽  
Second Year ◽  
One Year

This paper presents the results of a two-year study of the effects of alendronate (Fosamax?) on bone mass in 187 women with osteoporosis, mean age 57.68 years. Bone mass, i.e. bone mineral density (BMD) was measured at the lumbar spine. Measurements were performed prior to treatment, one year and two years after treatment using the DEXA method. The BMD was examined in 65 women, mean age 54.02, taking calcium and vitamin D, and in 75 women mean age 57.16, without any therapy. The baseline BMD (T score) in the alendronate group was -2.87 SD, whereas in the two control groups it measured -1.86 SD and -2.02 SD, respectively. A significant improvement of bone mass, by 5.8%, was registered after a year of treatment with alendronate, and by 8.3% after two years. In patients receiving calcium and vitamin D, a significant increase of bone mass was established as well: by 2.9% after a year, but the values declined back to the baseline after the second year. In patients without any treatment the bone mass decreased by 0.6% after a year, and by 0.9% after the second year. .

Bone Mineral Density in Normal Chinese Men and Women in Singapore

1997 ◽  
Vol 01 (01) ◽  
pp. 41-46 ◽  
Author(s):  
Soon Tai Lee ◽  
James Cho Hong Goh ◽  
Siew Leng Low ◽  
Kamal Bose
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Chinese Women ◽  
Reference Database ◽  
Age Group ◽  
Mineral Density ◽  
Significant Difference ◽  
Peak Bmd

169 men and 267 women aged 20 to 69 years had bone mineral density measured in the lumbar spine and femoral neck by dual energy X-ray absorptiometry (DXA). The male subjects were significantly taller and heavier than the female subjects. However, there was no significant difference in body mass indexes of males and females. In males, the regression of age on lumbar spine and femoral neck BMD was linear, with peak BMD attained in the 20–29 age group. In females, peak BMD occurred in the age group 30–39 years. The regression of BMD with age in females was best fit by a cubic regression curve. There was no difference in peak spine BMD (1.176 ± 0.121 g/cm2 for males versus 1.221 ± 0.129 g/cm2 for females; p < 0.01). However, males were found to have significantly higher peak BMD in the femoral neck (1.052 ± 0.119 g/cm2 for males versus 0.949 ± 0.108 g/cm2 for females; p < 0.01). When our data was compared to the reference database from the American and Japanese populations, it was found that Chinese women in Singapore and American women had similar BMD values and both groups had significantly higher BMD than the Japanese in both the lumbar spine and femoral neck.

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