Prevalence and risk factors of discordance in diagnosis of osteoporosis using spine and hip bone densitometry

Maghraoui, A. El; Abayi, D.A. Mouinga; Ghozlani, I.; Mounach, Aziza; Nouijai, A.; Ghazi, M.; Achemlal, L.; Bezza, A.

doi:10.1136/ard.2006.062372

Cited by 32 publications

(19 citation statements)

References 10 publications

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“…Very few individuals had normal status at one site and osteoporosis at the other site. Similar results regarding major discordance between the hip and spine have been reported by others [16][17][18][19][20].…”

Section: Discussionsupporting

confidence: 88%

Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status

et al. 2011

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Section: Discussionsupporting

confidence: 88%

Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status

et al. 2011

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“…In addition, a physiologic discordance between different skeletal sites could be related to the skeleton's natural adaptive reaction to physiological exogenous and endogenous influencing factors (39). Mechanical strain especially related to weight bearing plays a key role in this kind of discordance (40). Moreover, trabecular sites (such the lumbar spine) are known to have a more rapid rate of bone loss during the early postmenopause than cortical sites (like the proximal femur) (39-41).…”

Section: Discussionmentioning

confidence: 99%

FSHR gene polymorphisms influence bone mineral density and bone turnover in postmenopausal women

Rendina

Gianfrancesco

Filippo

et al. 2010

European Journal of Endocrinology

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Objective: FSH, via its receptor (FSHR), influences bone remodeling and osteoclast proliferation and activity. The aim of this study was to evaluate the influence of two single nucleotide polymorphisms (SNPs) of the FSHR gene on bone mineral density (BMD) and bone turnover markers (bone alkaline phosphatase and type I collagen C-telopeptides) in postmenopausal women. Methods: Two hundred and eighty-nine unrelated postmenopausal women were genotyped for the SNPs rs1394205 and rs6166. BMD was estimated using dual-energy X-ray absorptiometry and quantitative ultrasound (QUS) methodologies. Results: AA rs6166 women showed a lower BMD (femoral neck and total body), lower stiffness index (calcaneal QUS), and higher serum levels of bone turnover markers compared to GG rs6166 women. The prevalence of osteoporosis was significantly higher in AA rs6166 women compared with GG rs6166 women. These results were not influenced by circulating levels of FSH and estrogens. Conclusion: The SNP rs6166 of the FSHR gene significantly influences BMD in postmenopausal women. In particular, AA rs6166 women are at increased risk of postmenopausal osteoporosis compared with GG rs6166 women, independently of circulating levels of FSH and estrogens. Previous studies have demonstrated that this SNP influences cell and tissue response to hyperstimulation of FSHR in vivo and in vitro. Our study results appear in agreement with these experimental data and with known biological actions of FSH/FSHR system in bone homeostasis.

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“…Several studies have shown that T-score discordance can affect diagnosis and management of postmenopausal osteoporosis [9][10][11][12][13][14]. Inconsistencies in the diagnostic classification between skeletal sites also can be present in premenopausal women.…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

Z-score discordance and contributing factors in healthy premenopausal women with low bone mineral density: the Korean National Health and Nutrition Examination Survey 2008–9

et al. 2015

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The premenopausal period is important for bone health and prevention of future fractures, but measuring bone mineral density (BMD) at only one site may not be sufficient to determine therapeutic strategies for low BMD in premenopausal women due to the presence of Z-score discordance. In this study, we investigated Z-score discordance in addition to contributing factors of idiopathic low BMD in healthy premenopausal Korean women. We studied 3003 premenopausal women aged 18-50 years, without secondary causes for low BMD and history of fragility fracture, who had participated in the Fourth Korean National Health and Nutrition Examination Surveys (2008-2009). Low body mass index (BMI), low vitamin D level, and low body muscle mass were associated with low BMD even in premenopausal women. Risk factors differed depending on the anatomic site. Low BMI and low vitamin D level were risk factors for low femoral neck BMD (FN-BMD), but not for low lumbar spine BMD (LS-BMD). Only total muscle mass had a slight effect on low LS-BMD. Z-score discordance was much higher than expected, in 75 and 73.8 % of the low LS-BMD and low FN-BMD groups, respectively. Our findings suggest the need to consider BMD discordance in premenopausal women and also to provide information on correctable factors affecting low BMD in younger populations. Long-term follow-up is needed to evaluate the possible effect of Z-score discordance on the prognosis of osteoporosis and subsequent fracture risk.

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Prevalence and risk factors of discordance in diagnosis of osteoporosis using spine and hip bone densitometry

Cited by 32 publications

References 10 publications

Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status

Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status

FSHR gene polymorphisms influence bone mineral density and bone turnover in postmenopausal women

Z-score discordance and contributing factors in healthy premenopausal women with low bone mineral density: the Korean National Health and Nutrition Examination Survey 2008–9

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