This study was designed to determine age- and gender-based normative values for spinal bone mineral density (BMD) in a Chinese population. In addition, we compared our data with those of other countries and populations. Four hundred and forty-three healthy Chinese subjects, aged 10-79 years (189 males, mean age 46.9 years; 254 females, mean age 45.7 years) were recruited for BMD assessment. BMD was measured by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA), including posteroanterior DXA (PA-DXA), lateral DXA (L-DXA) and midlateral DXA (mL-DXA). For both genders, BMD values peaked in the 10-19 year age group when measured by QCT, and in the 30-39 year age group when measured by PA-DXA. BMD values decreased with age after reaching peak bone density in males and females for all measurements, except for PA-DXA in males. Male BMD values by DXA tended to increase beginning with the 60-69 age group through the 70-79 age group whether by PA-DXA, or L-DXA and mL-DXA. However, male QCT data showed stable BMD values among these two older groups. Comparative results showed female QCT data were higher in the 20-39 age group and lower after the 40-49 age group compared with American females. The peak BMD value by PA-DXA in Chinese females was reached in the same age group as American and European females and was similar in magnitude (p > 0.05). However, the peak BMD value for Chinese females was reached earlier and was significantly higher than that observed in Japanese females (p < 0.001). We conclude that the age group in which the peak BMD values are reached is different depending on the technique used, as is the calculated age-related rate of bone loss. It can be speculated that such differences reflect different timing for bone maturation in cancellous and cortical bone.
Abstract:We studied bone mineral content and density (BMC/BMD) and bone turnover markers in normal Chinese women from the age of 20 to 80 years and compared the data with those for normal women from the Western part of the world (Denmark). In all subjects (5 at each age; n = 305) BMC and BMD were determined at three sites of the nondominant forearm with single X-ray absorptiometry (SXA). In addition, 10 women had five repeated measurements to determine the reproducibility of the equipment, demonstrating coefficients of variation of 1%-2% depending on the measurement site. The Chinese premenopausal women were on the average heavier (1 kg) than the postmenopausal women, but they were also taller (6 cm). The postmenopausal women had highly significantly less bone mass than the premenopausal women; 15% at the 88 site, 25% at the 8-mmdistal site, and 35% at the ultradistal site. At age 50, bone mass in Chinese women was very similar to that of a comparable group of Danish women. After age 50, bone loss accelerated and the rate of loss seemed more rapid in the Chinese than in the Danish women. Within the first 5 postmenopausal years, the most cortical part decreased by approximately 3.9%, the mixed cortical and trabecular site by 9.5%, and the mainly trabecular site by 16.2%. In the following 5 years the decreases were 6.3%, 5.5%, and 6.6%, respectively, and 5.6%, 11.3%, and 8.9% for year 11-15 after menopause. The bone decrement continued throughout the 25th year of menopause, and except for the ultradistal site, the rate of loss did not change very much. The postmenopausal women had highly significantly higher levels of all bone turnover markers than premenopausal women. The markers stayed high at all ages. We conclude that the present study gives the normal values of Chinese women's bone mass at three sites of the distal forearm. The data were collected in a way which allows them to be used as reference for normal Chinese women. The data demonstrate that women from the East and West are relatively similar in terms of bone mass. Offprint requests to: B.
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