Effects of the sample size of reference population on determining BMD reference curve and peak BMD and diagnosing osteoporosis

Hou, Yanli; Liao, Er-Yuan; Wu, Xi-Yu; Peng, Yi-Qun; Zhang, H.; Dai, Renke; Luo, Xi; Cao, Xing-Zhi

doi:10.1007/s00198-007-0436-7

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…[6, 7] and there are significant differences in BMD between peer age groups of different sexes and areas [7, 8]. Reference ranges may thus vary in different populations [9, 10]. The World Health Organization densitometric definition of osteoporosis, based on fracture risk, strictly pertains only to postmenopausal Caucasian women [11].…”

Section: Introductionmentioning

confidence: 99%

Normative bone mineral density data at multiple skeletal sites in Indian subjects

et al. 2008

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SummaryAge-related change in bone mineral density (BMD) varied according to skeletal site in Indian subjects. A larger proportion of subjects was classified as osteoporotic and osteopenic using the Caucasian database than newly derived peak BMD values at most skeletal sites. Results establish useful normative data for reliable interpretations of individual dual-energy X-ray absorptiometry (DEXA) valuesIntroductionOsteoporosis is believed to occur at a relatively younger age in the Indian population. With increasing knowledge on significant differences in BMD between various racial groups, there is increased emphasis for the use of population-specific reference database.MethodsBMD at multiple skeletal sites was measured using DEXA (Prodigy, Lunar) in 615 Indian women (20–86 years) and 489 Indian men (20–83 years). Best-fit models were drawn for each skeletal site. Osteopenia and osteoporosis diagnosis rates were calculated using Caucasian and derived Indian peak BMD values.ResultsAge-related change in BMD varied with skeletal site in both sexes. Peak BMD in women was observed between 31 and 40 years of age at the hip, spine, and radius 33% and between 20 and 30 years at the ultradistal radius. Peak BMD in men was attained between 20 and 30 years at the hip and radius 33% and between 31 and 40 years at the spine and ultradistal radius. A larger proportion of Indian subjects was classified as osteoporotic and osteopenic based on the Caucasian database than newly derived Indian peak BMD values at all skeletal sites except radius 33% and femoral neck in females above 40 years of age.ConclusionResults establish useful normative data for the Indian population for reliable interpretations of individual DEXA values.

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Section: Introductionmentioning

confidence: 99%

Normative bone mineral density data at multiple skeletal sites in Indian subjects

et al. 2008

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“…This design aimed to control boundary effect, which refers to the larger imprecision of estimation at the extremes of the age range, which are often undersampled, than near the mean . Findings by Hou and collegues also supported age‐stratified design. They reported that varying sample size from 3662 to 458 had no significant effect on fitting areal BMD reference curves provided that the sample size was reasonably distributed across age range.…”

Section: Discussionmentioning

confidence: 85%

Normative Standards for HRpQCT Parameters in Chinese Men and Women

Zhu

Yip

Hung

et al. 2018

Journal of Bone and Mineral Research

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Assessing bone architecture using high-resolution peripheral quantitative computed tomography (HRpQCT) has the potential to improve fracture risk assessment. The Normal Reference Study aimed to establish sex-specific reference centile curves for HRpQCT parameters. This was an age-stratified cross-sectional study and 1072 ambulatory Chinese men (n = 544) and women (n = 528) aged 20 to 79 years, who were free from conditions and medications that could affect bone metabolism and had no history of fragility fracture. They were recruited from local communities of Hong Kong. Reference centile curves for each HRpQCT parameter were constructed using generalized additive models for location, scale, and shape with age as the only explanatory variable. Patterns of reference centile curves reflected age-related changes of bone density, microarchitecture, and estimated bone strength. In both sexes, loss of cortical bone was only evident in mid-adulthood, particularly in women with a more rapid fashion probably concurrent with the onset of menopause. In contrast, loss of trabecular bone was subtle or gradual or occurred at an earlier age. Expected values of HRpQCT parameters for a defined sex and age and a defined percentile or Z-score were obtained from these curves. T-scores were calculated using the population with the peak values as the reference and reflected age- or menopause-related bone loss in an older individual or the room to reach the peak potential in a younger individual. These reference centile curves produced a standard describing a norm or desirable target that enables value clinical judgements. Percentiles, Z-scores, and T-scores would be helpful in detecting abnormalities in bone density and microarchitecture arising from various conditions and establishing entry criteria for clinical trials. They also hold the potential to refine the diagnosis of osteoporosis and assessment of fracture risk. © 2018 American Society for Bone and Mineral Research.

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“…All subjects were screened using a detailed questionnaire, historical intake, and physical examination. 15,16 According to the World Health Organization (WHO) definition 17 and the BMD reference databases established by Wu XY et al and Hou YL et al, 15,16 subjects with a BMD of 1.0 SD or 2.5 SD lower than the peak BMD of the same gender (T-scores ≤−1.0 and ≤−2.5) were determined to be osteopenic or osteoporotic, respectively.…”

Section: Developedmentioning

confidence: 99%

“…BMD was measured by dual energy X-ray absorptiometry (DXA) using a Lunar device (Lunar DPX IQ, Waltham, MA, USA) for various skeletal regions, including the posteroanterior lumbar spine (Lumbar spine, L1-L4) and the left femoral neck. 15,16 All calculations were performed using SPSS V19.0 for Windows (SPSS Inc., Chicago, IL, USA). The results are provided as the mean and standard deviation (mean ± SD).…”

Section: Developedmentioning

confidence: 99%

Increased serum GDF11 concentration is associated with a high prevalence of osteoporosis in elderly native Chinese women

Jin

Song

Guo

et al. 2016

Clin Exp Pharma Physio

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Osteoporosis is an age-related disease. Many studies have confirmed the anti-aging effect of growth differentiation factor 11 (GDF11), but the action of GDF11 on bone metabolism remains unclear. In this study, we aimed to investigate the relationship between serum GDF11 levels and the prevalence of osteoporosis. Our data indicate negative correlations between serum GDF11 levels and BMD at the lumbar spine and femoral neck. The serum GDF11 levels were grouped into quartile intervals, and the prevalence and risk of osteoporosis were found be markedly greater with increased GDF11 levels. This study demonstrated that GDF11 was negatively correlated with BMD in elderly Chinese women. Furthermore, osteoporotic risk was significantly increased with increases in GDF11 levels.

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Effects of the sample size of reference population on determining BMD reference curve and peak BMD and diagnosing osteoporosis

Abstract: Varying the sample size from hundreds to thousands has no decisive effect on establishing BMD reference curve and determining peak BMD. It should be practical for determining the reference population while establishing local BMD databases.

Cited by 9 publications

References 25 publications

Normative bone mineral density data at multiple skeletal sites in Indian subjects

Normative bone mineral density data at multiple skeletal sites in Indian subjects

Normative Standards for HRpQCT Parameters in Chinese Men and Women

Increased serum GDF11 concentration is associated with a high prevalence of osteoporosis in elderly native Chinese women

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