Bone Mineral Density Reference Values Research Articles

Comparison of the prevalence of osteoporosis in people with spinal cord injury according to bone mineral density reference values for the diagnosis of osteoporosis: a retrospective, cross-sectional study

BackgroundSpinal cord injury (SCI) is a complex cause of rapid low bone mass that easily predisposes the affected individuals to osteoporosis-induced fractures. Several studies have investigated osteoporosis pathophysiology in SCI; however, those associated with its diagnosis in SCI are limited. Additionally, errors in osteoporosis diagnosis and its prevalence vary based on the bone mineral density (BMD) reference values (BMDRV), and no studies have reported BMDRV application for osteoporosis diagnosis in individuals with SCI. Therefore, this study aimed to compare the prevalence of osteoporosis among Korean adults aged ≥ 50 years with SCI according to BMDRV for diagnosing osteoporosis.MethodsOverall, 855 patients with SCI who underwent BMD tests of the lumbar spine, femoral neck, and total hip at the National Rehabilitation Center (NRC) in Korea between 2010 and 2020 were included in this retrospective cross-sectional study. Osteoporosis was diagnosed in patients with SCI by comparing the differences in prevalence, diagnostic consistency, and risk factors according to the region-based BMDRV of the dual-energy x-ray absorptiometry (DXA) manufacturer and international BMDRV based on the Third National Health and Nutrition Examination Survey (NHANES III) data of females aged 20–29 years.ResultsThe prevalence of osteoporosis according to the T-score provided by a single reference population of the NHANES III (TNHA) (PONHA) (males: 26.69%; females: 69.35%) was significantly higher in females and males than that according to the T-scores provided by the DXA manufacturer (TDXA) (PODXA) (males: 15.32%; females: 43.15%). The lumbar spine and femoral neck were major osteoporosis diagnosis sites for the PODXA and PONHA, respectively. Risk factors for osteoporosis differed based on the probability of osteoporosis (also known as the OZ ratio) according to the BMD criteria; however, the risk factors were similar according to old age, female sex, low body mass index (BMI), and long SCI period. No significant relationship was noted between the different SCI-related clinical factors (p > 0.05).ConclusionsThe osteoporosis diagnostic site and prevalence in SCI differed according to the regional-based TDXA and international standards of the TNHA. Therefore, further studies on BMDRV are warranted to establish accurate diagnostic criteria for osteoporosis prevention in patients with SCI.

Bone Mineral Density Reference Values in 18- to 95-Year-Old Population in Lombardy Region, Italy.

The aim of this study is to assess the bone mineral density (BMD) and T-score reference values in a population from 18 to 95 years old in Lombardy region, Italy. This study also investigates the association between BMD values and body mass index (BMI) divided by gender and age. The evaluation of BMD was analyzed by T-score and BMD in each site, femur, and column. A total of 10,503 patients (9,627 females and 876 males, 65.04±12.18 years) have been enrolled in this study. The women hip femur reference values associated with a situation of osteopenia highlighted in-line with the class of age of 45 to 55 years were: mean values: -1.3132 T-score; 95% confidence interval (CI): -1.3600 to -1.2664 and of osteoporosis from the class of age 85 to 95 years, mean values: -2.6591 T-score, 95% CI: -2.7703 to -2.5479. The men hip femur reference values associated with a situation of osteopenia highlighted in-line with the class of age of 45 to 55 years were: mean values: 1.2986 T-score; 95% CI: -1.5454 to -1.0518. A positive association between BMI and the two sites of BMD was recorded (p > .05). This study provides an Italian overview of national and regional reference values about the BMD and T-score values divided by age and gender as reference values for clinicians for a correct assessment and monitoring.

Bone mineral density reference values by DXA scan in a population of healthy adults in Bogota

IntroductionThe current definition of osteoporosis is based on the dual energy X-ray absorptiometry (DXA), which represents the main technique for the quantification of bone mineral density (BMD) and the evaluation of fracture risk. The objective of this study was to determine the bone mineral density in the lumbar spine and femoral neck of healthy adults from a bone metabolism point of view in a population of Bogotá-Colombia. MethodAn observational, analytical, cross-sectional study was conducted based on a questionnaire completed by the study population. The densitometric measurements were carried out using a high-performance compact equipment of the General Electric, iDXA model, by the same technologist at the skeletal sites of interest, lumbar spine L1, L2, L3, L4 and L1-4 in anteroposterior projection (AP), and in femoral neck. The sample size calculation was performed taking into account stratification by gender and 2 age groups: 20–29 years, and 30–39 years. A total of 805 individuals were surveyed, and 432 bone densitometries were performed. ResultsThe values found in the lumbar spine for each of the groups in our population were: 1.150 g/cm2 (SD: 0.11), 1.180 g/cm2 (SD: 0.10), for women and men aged 20–29 years, and 1.169 g/cm2 (SD: 0.10), 1.209 g/cm2 (SD: 0.10) for women and men aged 30–39, respectively. At the level of the femoral neck, 0.991 g/cm2 (SD: 0.10), 1.119 g/cm2 (SD: 0.13), for women and men aged 20–29 years, respectively, and 0.970 g/cm2 (SD: 0.11), 1.079 g/cm2 (SD: 0.13) for women and men aged 30–39, respectively. ConclusionThis study was able to demonstrate the behavior of bone mineral density in our population, which is lower than that detected in other latitudes and those used as reference values in our equipment. Additionally, the maximum bone mass value was determined in each of the locations of interest for the age ranges of the population in our study.

Pediatric Dual-Energy X-Ray Absorptiometry in Japan: A Proposal for Shared Access to Equipment

Regular assessment of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) is essential for detecting glucocorticoid-induced osteoporosis in juvenile-onset autoimmune diseases. Z-score is used to standardize osteoporosis assessment in children and is evaluated with only one of three devices in Japan. The purpose of this study was to determine how many Japanese medical facilities for pediatric rheumatic diseases were unable to use Z-scores to evaluate osteoporosis. Electronic questionnaires were distributed between 2017 and 2019 to hospitals belonging to the Pediatric Rheumatology Association of Japan and to university hospitals and public children's hospitals that provide medical care for pediatric rheumatic diseases. The questionnaire inquired about the location of DXA measurement, manufacturer (Hologic, GE healthcare, Hitachi), and measurement site, and the answers were collected using Google Forms. Statcel 4 was used for analysis. Overall, 120 facilities responded to the survey, of which 117 had DXA. In the remaining three facilities, DXA was not installed in two and was out of order in one. Bone loss in childhood was evaluated using a Z-score calculated from age-based reference values; however, 30% of hospitals without HOLOGIC DXA could not evaluate osteoporosis by Z-score in Japanese childhood. The characteristics of the hospitals enrolled in this study did not bias the selection of Hologic DXA. Neighboring institutions should consider sharing access to Hologic DXA equipment, to ensure use of uniform reference values. GE BMD reference values should be established for Japanese children.

Bone mineral density in healthy Syrian women measured by dual energyX-ray absorptiometry

Assessment of bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA) technique is considered as a standard technique for diagnosing osteopenia and osteoporosis and evaluating the severity of such diseases. Numerous studies have demonstrated the necessity to establish an ethnicspecific reference data for Bone mineral density measurements. Such data are lacking for the Syrian population. The objectives of this study are (1) to establish BMD reference values in a group of healthy Syrian women using DXA technique, (2) to compare with values from other populations, (3) to study the prevalence of osteopenia and osteoporosis in Syrian women using the manufacturer reference values. A total of 951 healthy Syrian women aged 20-79 years participated in this study. Weight, height, and BMI have been determined. BMD measurements were performed using Lunar Prodigy Advance System (GE).
 The data were compared with those from other populations. The results have demonstrated the expected decline in BMD with age after peaking at 30-39 years old group. The peak values of the lumbar spine and femur neck were 1.16 (0.12), and 0.95 (0.13) g/cm2, respectively. The results of the Syrian women were compared with those from other populations and the differences were presented. Osteopenia was diagnosed in 35.80% and 60.31% and osteoporosis in 6.23% and 2.72% in lumbar spine and femur neck, respectively, of women 50-59 years of age. These ratios increased to 36.84%, 68.42% and 23.68%, 13.10%, respectively, in the age group more than 59 years. BMD values of the Syrian women were determined for the first time. The results demonstrate the importance of establishing population-specific reference range for BMD values for an accurate assessment of Osteoporosis. High prevalence of osteopenia and osteoporosis was demonstrated in Syrian using the manufacturer reference values.

Bone mineral density reference standards for Chinese children aged 3–18: cross-sectional results of the 2013–2015 China Child and Adolescent Cardiovascular Health (CCACH) Study

ObjectivesNo nationwide paediatric reference standards for bone mineral density (BMD) are available in China. We aimed to provide sex-specific BMD reference values for Chinese children and adolescents (3–18 years).MethodsData (10...

Normative data for calcaneal broadband ultrasound attenuation among children and adolescents from Colombia: the FUPRECOL Study.

Quantitative ultrasound (QUS) has been found to be a safe and reliable method for evaluating bone mineral density (BMD). Using calcaneal QUS techniques, the current study contributes to remedying this gap in the literature by establishing normative data among children and adolescents from Colombia. Minimal data on BMD changes are available from populations in developing countries. BMD reference values for children and adolescents have not been published for a Latin-American population. The aim of this study was to establish a normal reference range of calcaneal broadband ultrasound attenuation (BUA) in Colombian children and adolescents with ages ranging from 9 to 17.9 years. A sample of 1001 healthy Colombian youth (boys n = 445 and girls n = 556), children, and adolescents (9-17.9 years old) participated in the study. A calcaneus QUS parameter (BUA) was obtained for boys and girls, stratified by age group. Furthermore, height, weight, fat mass percentage, and body mass index were measured. Centile smoothed curves for the third, tenth, 25th, 50th, 75th, 90th, and 97th percentiles were calculated using the LMS method (L [curve Box-Cox], M [curve median], and S [curve coefficient of variation]). Mean (± SD) values for the participants' anthropometric data were 12.9 ± 2.3 years of age, 45.2 ± 11.5 kg weight, 1.51 ± 0.1 m height, 19.5 ± 3.1 kg/m(2) BMI, and 69.5 ± 17.1 dB/MHz BUA. Overall, all variables were significantly higher in boys except in BMI and body fat percentage. Girls generally had higher mean calcaneal BUA (dB/MHz) values than the boys, except in the age ranges 16 and 17.9, p > 0.05. In addition, the BUA (dB/MHz) increased with age throughout childhood and adolescence and reached a plateau by age 15-17.9 for girls. For the first time, our results provide sex- and age-specific BUA reference values for Colombian children and adolescents aged 9-17.9 years. A more specific set of reference values is useful for clinicians and researchers and informs clinical practice to monitor bone mineral status.

Bone mineral density: reference values and correlates for Bangladeshi women aged 16-65 years.

Studies examining the reference values of bone mineral density (BMD) and their patterns at different ages are largely based on data generated from developed countries. The objective of this study was to estimate reference values of BMD, along with their correlates, for women living in urban and suburban areas of Bangladesh. Dual-energy X-ray absorptiometry scans were performed on 500 women 16-65 years of age. Reference values at the lumbar spine (LS) and femoral neck (FN) were estimated after adjusting for height and weight. In addition, multiple linear regression analysis was used to examine correlates of BMD at the LS and FN. Mean BMD was highest at the LS and FN in women 16-19 (1.001-1.007 g/cm(2)) and 16-22 years of age (0.880-0.888 g/cm(2)), respectively, and gradually declined with increasing age thereafter. BMD decreased at an annual rate of 0.0027 g/cm(2) at the LS and 0.0046 g/cm(2) at the FN among women aged 16-45 years. For women 46-65 years of age, the respective figures were 0.0073 and 0.0083 g/cm(2). In both age groups, body weight was positively associated with BMD at both sites, and with height only at the LS. In addition, years of pill use was positively associated with BMD at the LS among women aged 16-45 years. BMD levels at both sites began to decline during the early twenties among Bangladeshi women. Age-specific BMD data generated in this study could be useful for interpreting bone densitometry data among women in Bangladesh and other South Asian countries.

In Urban Areas of Sivas City the Determination of Bone Mineral Density Reference Values of Healthy Women Who Admitted to Cumhuriyet University Hospital Physical Medicine and Rehabilitation Outpatient Clinic

In Urban Areas of Sivas City the Determination of Bone Mineral Density Reference Values of Healthy Women Who Admitted to Cumhuriyet University Hospital Physical Medicine and Rehabilitation Outpatient Clinic

Hand bone mineral density reference values in a Turkish healthy female population

In this study we aimed at identifying the bone mineral density (BMD) reference values of hands, according to age, measured by dual-energy X-ray absorptiometry (DEXA) and assessing the correlation of these values with lumbar and femoral BMD values. A total of 403 healthy women aged between 20 and 70 participated in our study. All BMD measurements are performed by DEXA method on both hands, anteroposterior lumbar spine (L2-L4) and right femur (femoral neck, total femur) regions. BMD results of all the patients were divided to 10-year age categories and evaluated in five subgroups in total (20-30 to 61-70). Among the 10-year age categories we found both dominant and non-dominant hand peak bone mass values in the 31-40years age group (0.423±0.039g/cm², 0.410±0.043g/cm², respectively). Statistically significant positive correlation was defined between dominant and non-dominant hand BMD values and L2-L4 spine, femur neck and total femur values (for dominant hand r=0.636, P=0.0001; r=0.645, P=0.0001; r=0.623; P=0.0001; for non-dominant hand r=0.624, P=0.0001; r=0.637, P=0.0001, r=0.623, P=0.0001, respectively). Regarding the relationship of age and menopause with BMD results, a negative statistical relationship was observed among dominant and non-dominant hand, L2-L4 spine, femoral neck and total femur BMD values (P=0.0001). Our study has provided hand BMD reference values in women aged between 20-70years; further studies are needed to investigate the role of these values in identifying diseases causing osteoporosis in the hand and in evaluating treatment.

Definition of a population‐specific dual energy X‐ray absorptiometry reference standard in Isfahani women

AbstractObjective: There are some clues that correct interpretation of bone mineral density (BMD) when measured by dual‐energy X‐ray absorptiometry (DXA) which requires a population specific reference range. We determined reference values of BMD and the prevalence of osteopenia and osteoporosis in postmenopausal Isfahani women.Methods: In this cross‐sectional study, 1118 healthy women from Isfahan, aged between 20 and 80 years were recruited door‐to‐door for research. BMD was measured at the anteroposterior lumbar spine (L2–L4) (AP) and femoral neck (FN) with the Lunar DPX‐IQ densitometer. Peak bone mass (PBM), reference curves of BMD, prevalence of osteoporosis and osteopenia were determined according to World Health Organization (WHO) criteria.Results: In Isfahani women osteoporosis and osteopenia of the AP lumbar spine exists at BMD < 0.898 g/cm2 and between 1.078 g/cm2 and 0.898 g/cm2, respectively. At the FN a BMD < 0.676 g/cm2 defines osteoporosis whereas osteopenia is defined as a BMD between 0.841 g/cm2 and 0.676 g/cm2. The prevalence of osteoporosis and osteopenia at the AP lumbar spine in the age groups 51–55, 56–60, 61–65, 66–70, > 70 years were, 7.9%, 19.6%, 26%, 32.1%, 31.8%, and 28.9%, 36.5%, 38.4%, 41.1%, 45.5%, respectively. The prevalence of osteoporosis and osteopenia at the FN in the same age groups, were, 2.6%, 2%, 12.3%, 14.3%, 22.7% and 28.3%, 39.9%, 43.8%, 50%, 68.2%, respectively.Conclusions: Our data would use a population‐specific reference range for DXA measurements and to estimate the prevalence of osteopenia and osteoporosis.

Population-based reference values for bone mineral density in young men

Population-based reference values for peak bone mass density in Danish men. BMD of total hip (1.078 +/- 0,14 g/cm2) differed significantly from values from National Health and Nutrition Examination Survey III and of total lumbar spine ((1.073 +/- 0.125 g/cm2) differed significantly from Hologic values. Geographic, ethnic, and socio-economic factors are known to affect bone mineral density (BMD) and peak bone mass significantly. Reference values for male peak bone mass are scarce, and the diagnosis of male osteoporosis often relies on values provided by producers of dual-energy X-ray absorptiometry (DXA) equipment. The aim of the present study was 1) to establish population-based reference values for BMD in young men and 2) to study subgroups based on variables with suspected impact on bone metabolism. We included 783 young Caucasian men aged 20 to 30 years in the Odense Androgen Study (OAS). Peak BMD was attained within the third decade. Obesity (BMI > 30 kg/m2) was associated with higher BMD. Abuse of anabolic steroids as well as chronic illness was associated with lower BMD. Our population-based reference values for BMD of the total hip (1.078 +/- 0.14 g/cm2) differed significantly from published values from National Health and Nutrition Examination Survey III for non-Hispanic white men, while BMD of total lumbar spine (1.073 +/- 0.125 g/cm2) differed significantly from Hologic reference values. Locally derived reference values are important to avoid false positive or false negative findings during work-up in patients evaluated for osteoporosis.

Bone Mineral Density of the Spine and Femur in Healthy Moroccan Women

Bone mineral density (BMD) measurements using dual-energy X-ray absorptiometry (DXA) are widely used to diagnose osteoporosis and assess its severity. Previous studies show the necessity to establish reference data for bone mass measurements for each particular population. Such data are lacking for the Moroccan population. The aim of this study was to determine spine and femur BMD reference values for the Moroccan female population and to compare them with values from western and other Arab countries. A cross-sectional study of 569 Moroccan women, (randomly selected in the area of Rabat, the capital of Morocco, aged between 20 and 79 yr) was carried out to establish reference values of BMD. Measurements were taken at the lumbar spine and proximal femurs using DXA (Lunar Prodigy Vision, GE). The data were compared with published normative data taken by United States (U.S.), European, Kuwaiti, Lebanese, and Saudi women over 6 decades of age. The percentage of osteoporosis in postmenopausal women using our reference curve was compared to that observed when the other curves (US, European and Arab) implemented in the Lunar machine was used. Our results showed that the Moroccan women showed the expected decline in BMD at both sites with age after peaking at 20-29 years of age. Moroccan females have lower BMD at the spine than U.S., Europeans, and Kuwaitis (approximately 10-12% for patients older than 50 yr). The BMD values of the total femur in Moroccan females were close to western (European and American), and Kuwaitis, but higher than Lebanese and Saudis. Using our reference database, 37.9% of postmenopausal women had spine osteoporosis vs. 39.6% and 23.4% using US/European and Arabic Lunar reference values respectively. At the femurs, 6.7% had osteoporosis vs. 2.5% using the Arabic Lunar reference values. In conclusion, our study emphasizes the importance of using population-specific reference values for BMD measurements to avoid over or underdiagnosis of osteoporosis.

Quantitative Computed Tomography BMD Reference Values in Women of I?zmir, Turkey

In quantitative computed tomography applications for the diagnosis of osteoporosis, the bone mineral density value obtained has to be compared with a reference data. This data is influenced by several factors including sex, age, and ethnicity. Therefore, reference data that accurately represent the population at large is essential. We established age-based quantitative computed tomography bone mineral density reference values for healthy women residing in Izmir, Turkey. We recruited 396 healthy women from 20 to 83 years old (mean age, 51.08 years). Quantitative computed tomography bone mineral density measurements were performed using the GE 9800 Highlight Advantage scanner at the L1, L2, and L3 lumbar vertebrae. The mean bone mineral density (mg/cm) +/- standard deviation of the normal reference group of women from 20 to 39 years old was 168.86 mmg/cm3 +/- 21.59. The threshold bone mineral density value for osteoporosis at a T score < -2.5 was 114.83 mg/cm3. The slope, intercept, and r values at bone mineral density versus age linear regression test were -2.44, 251.1, and 0.70, respectively. The percentage of annual bone mineral density loss was 1.6%. The bone mineral density values of Turkish women were not distinct from most countries' reference values. Diagnostic study, Level II (Development of diagnostic criteria on consecutive patients [with universally applied reference "gold" standard]). See the Guidelines for Authors for a complete description of the levels of evidence.

Bone mineral density reference norms for Hong Kong Chinese

The aim of this study was to establish bone mineral density (BMD) reference norms for Hong Kong Chinese using Hologic QDR 2000 and 4500 densitometers, and to estimate the prevalence of osteoporosis in the population. Altogether, 4,274 subjects (2,415 females and 1,859 males), aged 9-94 years old, were recruited using a combination of private solicitation and public advertising from schools, community centers, nursing homes, housing estates, and the general community in Hong Kong. Among females, BMD increased by 20% at the total hip and 48% at the lumbar spine between ages 10 and 20 but remained essentially constant between ages 20 and 40. Between ages 40 and 70, BMD declined by 17% at the total hip and 23% at the spine. Total hip BMD continued to drop after age 70 but little change in spine BMD was observed. Among males, BMD increased by 45% at the total hip and 77% at the spine between age 10 and 30. Between ages 30 and 80, total hip BMD decreased by 20%. Lumbar spine BMD decrease was milder, showing a loss of 4% between ages 30 to 50 and remaining relatively constant afterwards. The prevalence of osteoporosis was consistently overestimated when using Hologic-supplied Caucasian cutoffs as compared with local Chinese cutoffs. The prevalence of osteoporosis among Chinese women 50 years or older was 37% and 16% at the spine and total hip, respectively, while that among Chinese men 50 years or older was 7% and 6% at the spine and total hip, respectively. Prior studies have been limited by size or restricted to women. This study represents the largest sample of Hong Kong Chinese amassed to date, provides continuous BMD reference values from ages 10 to 85 for both women and men, and yields more reliable estimates of the prevalence of osteoporosis for the population.

Bone mineral density reference values in the normal female and male population of İzmir, Turkey

Bone mineral density reference values in the normal female and male population of İzmir, Turkey

Bone mineral density reference values in the normal female and male population of İzmir, Turkey

In this study we aimed to establish the dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) reference values of healthy Turkish women and men residing in Izmir, western Turkey. We examined 347 women and 119 men (age range 20-80 years) who did not have any known risk factor that might affect bone mass. The BMD measurements were performed by Hologic QDR 4500 W Elite DXA instrument from the lumbar spine (L1-L4) and non-dominant hip. In women the mean BMD (g/cm(2))+/-standard deviation (SD) of the normal reference group between 20 and 39 years of age was 0.963+/-0.121 g/cm(2) in the lumbar spine and 0.891+/-0.119 g/cm(2) in total femoral region. The percentages of annual and total BMD losses in women between 30 and 80 years of age were 0.74 and 29% at spinal level and 0.65 and 26% in femoral region, respectively. The average BMD of the normal men's group between 20 and 39 years of age was 0.996+/-0.111 g/cm(2) in the lumbar spine and 1.025+/-0.110 g/cm(2) in femoral region. The percentages of annual and total BMD losses were 0.33 and 13% at spinal level and 0.50 and 20% in femoral region, respectively. In conclusion, like the values reported from mid-Anatolian region of Turkey, the BMD values of Turkish women and men residing in Izmir, western Anatolia, are also lower than in most European countries with regard to US and preinstalled Hologic values.