An Updated Reference for Calculating Bone Mineral Density T-Scores

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.

Advances in the diagnosis and treatment of osteoporosis and sarcopenia

“…Another assessment method is Quantitative Computed Tomography (QCT), which measures volumetric Bone Mineral Density (BMD) in both trabecular and cortical bone. Nevertheless,this approach is not recommended due to its high economic cost and the greater ionizing radiation exposure requiblue for patients compablue to DXA scans [15]. Diagnosing osteoporosis can involve a bone tissue biopsy, an invasive technique that entails extracting tissue samples, typically only performed if there is evidence of a tumor [16].…”

Klotho Reduces the Risk of Osteoporosis in Postmenopausal Women: A cross-sectional Study of the National Health and Nutrition Examination Survey (NHANES)

“…Presently, the OP is de ned as the BMD of postmenopausal female interviewee is 2.5 or more SD lower than that of healthy adults of the same gender [32] . This study evaluated BMD in the lumbar spine and femoral neck and adopted a latest reference of BMD updated by Xue et al [33] .…”

Osteoporosis management in primary care

“…For every standard deviation below mean, fracture risk increases 50%-100%. 22 BMD scoring is important to determine diagnosis of osteoporosis before treatment begins. Individuals with a fragility fracture of the hip or spine have a diagnosis of osteoporosis regardless of BMD and should be started on treatment.…”

“…A T-score of more than one standard deviation below the T-score mean indicates lower than expected BMD for chronologic age, with lower scores signifying more severe bone loss, as summarized in Table 2. For every standard deviation below mean, fracture risk increases 50%-100% 22. BMD scoring is important to determine diagnosis of osteoporosis before treatment begins.…”