Evaluating the Performance of the WHO International Reference Standard for Osteoporosis Diagnosis in Postmenopausal Women of Varied Polygenic Score and Race

Abstract

Background: Whether the bone mineral density (BMD) T-score performs differently in osteoporosis classification in women of different genetic profiling and race background remains unclear. Methods: The genomic data in the Women’s Health Initiative study was analyzed (n = 2417). The polygenic score (PGS) was calculated from 63 BMD-associated single nucleotide polymorphisms (SNPs) for each participant. The World Health Organization′s (WHO) definition of osteoporosis (BMD T-score ≤ −2.5) was used to estimate the cumulative incidence of fracture. Results: T-score classification significantly underestimated the risk of major osteoporotic fracture (MOF) in the WHI study. An enormous underestimation was observed in African American women (POR: 0.52, 95% CI: 0.30–0.83) and in women with low PGS (predicted/observed ratio [POR]: 0.43, 95% CI: 0.28–0.64). Compared to Caucasian women, African American, African Indian, and Hispanic women respectively had a 59%, 41%, and 55% lower hazard of MOF after the T-score was adjusted for. The results were similar when used for any fractures. Conclusions: Our study suggested the BMD T-score performance varies significantly by race in postmenopausal women.

Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)

“…It is worth emphasizing, as stated in the previous sections, that interpretation of controversial data on HPI–OP/OF relationships should take into account the methodological weaknesses most of the available studies (the vast majority were cross-sectional). The conflicting results are likely due not only to differences in design, sample sizes, protocol and methodologies of determination HPI (often limited to seroprevalence only) as well as OP (T-score BMD method underestimates the OF risk in 56–82% [ 746 , 747 , 748 , 749 , 750 ]), but also—and more importantly—very limited information on specific microbiological characteristics of H.p., ignoring predominant site and severity of gastritis, heterogeneity in patient populations (wide variations in demographic, socioeconomic, lifestyle, dietary and environmental confounding factors, comorbidities, risk of falling, used medications), However, despite these limitations, the huge number of publications reporting significant links between HPI, particularly with virulent strains (cagA+), and the development, course and severity of different chronic gastroduodenal and extra-digestive diseases and disorders known to be associated with falls, OP and, consequently, OFs cannot be ignored. The topic requires reconsideration in well-designed prospective studies examining simultaneously the virulence factors of H.p.…”

Thyroid Hormone Diseases and Osteoporosis

“…The definition of osteoporosis is based on densitometric measurement of bone mass in the spine or hip and not on clinical criteria. The World Health Organization defines osteoporosis as a bone mineral density (BMD) 2.5 or more standard deviations (SDs) below that of a young adult at any site (T score), whereas osteopenia is defined when BMD is >1 SD and <2.5 SD lower than the young-adult mean end [1].…”

Association of bone-related biomarkers with femoral neck bone strength

“…Furthermore, DXA cannot effectively distinguish between trabecular and cortical bone, the different metabolic rate between trabecular and cortical bone may affect BMD testing results [ 8 ]. The Fracture Risk Assessment Tool (FRAX) is the most widely used tool for fracture risk assessment, which computes the 10-year probability of major osteoporotic fracture and hip fracture [ 9 ]. FRAX improves fracture prediction over the BMD measurement alone, however, the FRAX performance of predicting fracture risk varies in different study populations.…”