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Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis

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Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis. / Wang, Ling; Ran, Limei; Zha, Xiaojuan; Zhao, Kaiping; Yang, Yingying; Shuang, Qing; Liu, Yandong; Hind, Karen; Cheng, Xiaoguang; Blake, Glen M.

In: Archives of osteoporosis, Vol. 15, No. 1, 155, 01.12.2020.

Research output: Contribution to journalArticlepeer-review

Harvard

Wang, L, Ran, L, Zha, X, Zhao, K, Yang, Y, Shuang, Q, Liu, Y, Hind, K, Cheng, X & Blake, GM 2020, 'Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis', Archives of osteoporosis, vol. 15, no. 1, 155. https://doi.org/10.1007/s11657-020-00833-1

APA

Wang, L., Ran, L., Zha, X., Zhao, K., Yang, Y., Shuang, Q., Liu, Y., Hind, K., Cheng, X., & Blake, G. M. (2020). Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis. Archives of osteoporosis, 15(1), [155]. https://doi.org/10.1007/s11657-020-00833-1

Vancouver

Wang L, Ran L, Zha X, Zhao K, Yang Y, Shuang Q et al. Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis. Archives of osteoporosis. 2020 Dec 1;15(1). 155. https://doi.org/10.1007/s11657-020-00833-1

Author

Wang, Ling ; Ran, Limei ; Zha, Xiaojuan ; Zhao, Kaiping ; Yang, Yingying ; Shuang, Qing ; Liu, Yandong ; Hind, Karen ; Cheng, Xiaoguang ; Blake, Glen M. / Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis. In: Archives of osteoporosis. 2020 ; Vol. 15, No. 1.

Bibtex Download

@article{b17e51d2c3df4927977a7b47101da7d4,
title = "Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis",
abstract = "Summary: We compared the effect of anthropometric factors on osteoporosis diagnosis by quantitative computed tomography (QCT) and dual energy X-ray absorptiometry (DXA) and found QCT spine volumetric bone mineral density (vBMD) was not associated with body weight, body mass index (BMI) or DXA anteroposterior spine thickness. In contrast, DXA spine and hip areal bone mineral density (aBMD) were strongly associated with all three factors. Adjustment of DXA aBMD measurements improved consistency with QCT vBMD. Purpose: Although the diagnosis of osteoporosis using DXA T scores preferentially targets patients with BMI, there is evidence that obesity is not protective against fractures. The aim of this study was to compare the effect of anthropometric factors on osteoporosis diagnosis by QCT and DXA and investigate whether adjustment of DXA aBMD can achieve a more even distribution of diagnoses between slimmer and heavier individuals consistent with QCT. Methods: The participants were 964 men and 682 women referred for low-dose chest CT and DXA examinations as part of their employers{\textquoteright} health check-up programs. QCT vBMD was measured in the L1–L2 vertebrae and DXA aBMD in the spine and hip. The prevalence of osteoporosis in each tertile of BMI in participants aged > 50 years was evaluated based on their QCT and DXA findings, and then re-evaluated after adjustment to the mean BMI in each sex. Similar investigations were performed for body weight and DXA anteroposterior (AP) spine thickness. The effect of the adjustment of DXA aBMD for anthropometric factors on the correlation with QCT vBMD was also examined. Results: For spine QCT, correlations of age adjusted vBMD residuals against BMI were not statistically significant in men (P = 0.44) or women (P = 0.32). In contrast, slopes for aBMD residuals were all highly statistically significant (P < 0.001). There were similar findings for weight and AP spine thickness. Adjustment of DXA aBMD for anthropometric factors resulted in a more equal spread of diagnoses of osteoporosis and greater consistency with QCT. Conclusion: Our study highlights differences between DXA and QCT in their correlation with anthropometric factors and its effect on the diagnosis of osteoporosis. Adjustment of DXA T scores for anthropometric factors gave greater consistency with QCT vBMD. Further studies are required into whether adjusting DXA aBMD for anthropometric factors has a beneficial impact on the discriminative or predictive power for vertebral fracture.",
keywords = "BMI, Body weight, Diagnosis, DXA, Osteoporosis, QCT, Spine thickness",
author = "Ling Wang and Limei Ran and Xiaojuan Zha and Kaiping Zhao and Yingying Yang and Qing Shuang and Yandong Liu and Karen Hind and Xiaoguang Cheng and Blake, {Glen M.}",
year = "2020",
month = dec,
day = "1",
doi = "10.1007/s11657-020-00833-1",
language = "English",
volume = "15",
journal = "Archives of osteoporosis",
issn = "1862-3522",
publisher = "Springer London",
number = "1",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Adjustment of DXA BMD measurements for anthropometric factors and its impact on the diagnosis of osteoporosis

AU - Wang, Ling

AU - Ran, Limei

AU - Zha, Xiaojuan

AU - Zhao, Kaiping

AU - Yang, Yingying

AU - Shuang, Qing

AU - Liu, Yandong

AU - Hind, Karen

AU - Cheng, Xiaoguang

AU - Blake, Glen M.

PY - 2020/12/1

Y1 - 2020/12/1

N2 - Summary: We compared the effect of anthropometric factors on osteoporosis diagnosis by quantitative computed tomography (QCT) and dual energy X-ray absorptiometry (DXA) and found QCT spine volumetric bone mineral density (vBMD) was not associated with body weight, body mass index (BMI) or DXA anteroposterior spine thickness. In contrast, DXA spine and hip areal bone mineral density (aBMD) were strongly associated with all three factors. Adjustment of DXA aBMD measurements improved consistency with QCT vBMD. Purpose: Although the diagnosis of osteoporosis using DXA T scores preferentially targets patients with BMI, there is evidence that obesity is not protective against fractures. The aim of this study was to compare the effect of anthropometric factors on osteoporosis diagnosis by QCT and DXA and investigate whether adjustment of DXA aBMD can achieve a more even distribution of diagnoses between slimmer and heavier individuals consistent with QCT. Methods: The participants were 964 men and 682 women referred for low-dose chest CT and DXA examinations as part of their employers’ health check-up programs. QCT vBMD was measured in the L1–L2 vertebrae and DXA aBMD in the spine and hip. The prevalence of osteoporosis in each tertile of BMI in participants aged > 50 years was evaluated based on their QCT and DXA findings, and then re-evaluated after adjustment to the mean BMI in each sex. Similar investigations were performed for body weight and DXA anteroposterior (AP) spine thickness. The effect of the adjustment of DXA aBMD for anthropometric factors on the correlation with QCT vBMD was also examined. Results: For spine QCT, correlations of age adjusted vBMD residuals against BMI were not statistically significant in men (P = 0.44) or women (P = 0.32). In contrast, slopes for aBMD residuals were all highly statistically significant (P < 0.001). There were similar findings for weight and AP spine thickness. Adjustment of DXA aBMD for anthropometric factors resulted in a more equal spread of diagnoses of osteoporosis and greater consistency with QCT. Conclusion: Our study highlights differences between DXA and QCT in their correlation with anthropometric factors and its effect on the diagnosis of osteoporosis. Adjustment of DXA T scores for anthropometric factors gave greater consistency with QCT vBMD. Further studies are required into whether adjusting DXA aBMD for anthropometric factors has a beneficial impact on the discriminative or predictive power for vertebral fracture.

AB - Summary: We compared the effect of anthropometric factors on osteoporosis diagnosis by quantitative computed tomography (QCT) and dual energy X-ray absorptiometry (DXA) and found QCT spine volumetric bone mineral density (vBMD) was not associated with body weight, body mass index (BMI) or DXA anteroposterior spine thickness. In contrast, DXA spine and hip areal bone mineral density (aBMD) were strongly associated with all three factors. Adjustment of DXA aBMD measurements improved consistency with QCT vBMD. Purpose: Although the diagnosis of osteoporosis using DXA T scores preferentially targets patients with BMI, there is evidence that obesity is not protective against fractures. The aim of this study was to compare the effect of anthropometric factors on osteoporosis diagnosis by QCT and DXA and investigate whether adjustment of DXA aBMD can achieve a more even distribution of diagnoses between slimmer and heavier individuals consistent with QCT. Methods: The participants were 964 men and 682 women referred for low-dose chest CT and DXA examinations as part of their employers’ health check-up programs. QCT vBMD was measured in the L1–L2 vertebrae and DXA aBMD in the spine and hip. The prevalence of osteoporosis in each tertile of BMI in participants aged > 50 years was evaluated based on their QCT and DXA findings, and then re-evaluated after adjustment to the mean BMI in each sex. Similar investigations were performed for body weight and DXA anteroposterior (AP) spine thickness. The effect of the adjustment of DXA aBMD for anthropometric factors on the correlation with QCT vBMD was also examined. Results: For spine QCT, correlations of age adjusted vBMD residuals against BMI were not statistically significant in men (P = 0.44) or women (P = 0.32). In contrast, slopes for aBMD residuals were all highly statistically significant (P < 0.001). There were similar findings for weight and AP spine thickness. Adjustment of DXA aBMD for anthropometric factors resulted in a more equal spread of diagnoses of osteoporosis and greater consistency with QCT. Conclusion: Our study highlights differences between DXA and QCT in their correlation with anthropometric factors and its effect on the diagnosis of osteoporosis. Adjustment of DXA T scores for anthropometric factors gave greater consistency with QCT vBMD. Further studies are required into whether adjusting DXA aBMD for anthropometric factors has a beneficial impact on the discriminative or predictive power for vertebral fracture.

KW - BMI

KW - Body weight

KW - Diagnosis

KW - DXA

KW - Osteoporosis

KW - QCT

KW - Spine thickness

UR - http://www.scopus.com/inward/record.url?scp=85091973669&partnerID=8YFLogxK

U2 - 10.1007/s11657-020-00833-1

DO - 10.1007/s11657-020-00833-1

M3 - Article

AN - SCOPUS:85091973669

VL - 15

JO - Archives of osteoporosis

JF - Archives of osteoporosis

SN - 1862-3522

IS - 1

M1 - 155

ER -

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