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Background: Areal bone mineral density (aBMD) applied for osteoporosis diagnosis unavoidably results in the missingdiagnosis in patients with large bones and misdiagnosis in those with small bones. Therefore, we try to find a new adjusted index of bone mineral content (BMC) to make up shortcomings of aBMD in osteoporosis diagnosis. Methods: In this multi-center epidemiological study, BMC and aBMD of lumbar spines ( n = 5510) and proximal femurs ( n = 4710) were measured with dual energy X-ray absorptiometry (DXA). We analyzed the correlation between the bone mass and body weight in all subjects including four age groups (<19 years, 20–39 years, 40–49 years, >50 years). And then the body weight was used for standardizing BMC (named wBMC) and applied for the epidemiological analysis of osteoporosis. Results: The correlation of body weight and BMC is 0.839 to 0.931 of lumbar vertebra 1–4 (L 1–4 ), and 0.71 to 0.95 of femoral neck in different age groups. When aBMD was applied for diagnosing osteoporosis, the prevalence was 7.55%, 16.39%, and 25.83% in patients with a high, intermediate, and low body weight respectively. However, the prevalence was 21.8%, 18.03%, and 11.64% by wBMC applied for diagnosing osteoporosis. Moreover, the prevalence of osteoporosis increased by 3.76% by wBMC with the body weight increased by 5 kg. The prevalence decreased by 1.94% when the body weight decreased by 5 kg. Conclusions: wBMC can reduce the missed diagnosis in patients with large body weight and reduce misdiagnosis in those with small body weight. Including children, wBMC may be feasible for osteoporosis diagnosis individuals at any age.

Osteoporosis is a common finding following chronic obstructive pulmonary disease (COPD), but there are few reports on the relationship between bone mineral density (BMD) and the syndrome types described in traditional Chinese medicine (TCM) in patients with COPD. A cross-sectional medical survey was used in this study. Twenty-six male patients with COPD and 26 age-matched male healthy subjects were recruited. The symptom questionnaire survey of TCM was implemented, and thereafter the COPD patients were divided into two subgroups: type of deficiency of the lung and spleen (TDLS) and type of deficiency of the lung, spleen and kidney (TDLSK). BMD of lumbar spine (L2-4), non-dominant femoral neck (Neck), Ward's triangle (Ward's), and great trochanter (Troch) were measured by dual-energy x-ray absorptiometry. In addition, the other bone turnover markers were also examined. The results showed that BMD was much more decreased in TDLSK than that in TDLS patients (p < 0.05), and BMD in the patients of the TDLS subgroup without symptoms of kidney-vacuity has showed the decreased trend from healthy subjects to TDLS patients. Furthermore, there was a higher incidence of osteoporosis in patients with TDLSK compared with that in TDLS (p < 0.05, OR > 2.0). Therefore, the data suggest that: (1) BMD might be a marker more sensitive than the symptom for the diagnosis of kidney-vacuity in COPD patients; (2) the deficiency of kidney would be the key factor of bone mineral loss; and (3) that invigorating the kidney should be performed in the phase of TDLS in COPD patients in advance.

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