TY - JOUR
T1 - Opportunistic Screening Using Low-Dose CT and the Prevalence of Osteoporosis in China
T2 - A Nationwide, Multicenter Study
AU - For the China Health Big Data (China Biobank) project investigators
AU - Cheng, Xiaoguang
AU - Zhao, Kaiping
AU - Zha, Xiaojuan
AU - Du, Xia
AU - Li, Yongli
AU - Chen, Shuang
AU - Wu, Yan
AU - Li, Shaolin
AU - Lu, Yong
AU - Zhang, Yuqin
AU - Xiao, Xigang
AU - Li, Yue Hua
AU - Ma, Xiao
AU - Gong, Xiangyang
AU - Chen, Wei
AU - Yang, Yingying
AU - Jiao, Jun
AU - Chen, Bairu
AU - Lv, Yinru
AU - Gao, Jianbo
AU - Hong, Guo Bin
AU - Pan, Yaling
AU - Yan, Yan
AU - Qi, Huijuan
AU - Ran, Limei
AU - Zhai, Jian
AU - Wang, Ling
AU - Li, Kai
AU - Fu, Haihong
AU - Wu, Jing
AU - Liu, Shiwei
AU - Blake, Glen M.
AU - Pickhardt, Perry
AU - Ma, Yuanzheng
AU - Fu, Xiaoxia
AU - Dong, Shengyong
AU - Zeng, Qiang
AU - Guo, Zhiping
AU - Hind, Karen
AU - Engelke, Klaus
AU - Tian, Wei
PY - 2020
Y1 - 2020
N2 - Opportunistic screening for osteoporosis can be performed using low-dose computed tomography (LDCT) imaging obtained for other clinical indications. In this study we explored the CT-derived bone mineral density (BMD) and prevalence of osteoporosis from thoracic LDCT in a large population cohort of Chinese men and women. A total of 69,095 adults (40,733 men and 28,362 women) received a thoracic LDCT scan for the purpose of lung cancer screening between 2018 and 2019, and data were obtained for analysis from the China Biobank Project, a prospective nationwide multicenter population study. Lumbar spine (L1–L2) trabecular volumetric bone mineral density (vBMD) was derived from these scans using quantitative computed tomography (QCT) software and the American College of Radiology QCT diagnostic criteria for osteoporosis were applied. Geographic regional differences in the prevalence of osteoporosis were assessed and the age-standardized, population prevalence of osteoporosis in Chinese men and women was estimated from the 2010 China census. The prevalence of osteoporosis by QCT for the Chinese population aged >50 years was 29.0% for women and 13.5% for men, equating to 49.0 million and 22.8 million, respectively. In women, this rate is comparable to estimates from dual-energy X-ray absorptiometry (DXA), but in men, the prevalence is double. Prevalence varied geographically across China, with higher rates in the southwest and lower rates in the northeast. Trabecular vBMD decreased with age in both men and women. Women had higher peak trabecular vBMD (185.4 mg/cm3) than men (176.6 mg/cm3) at age 30 to 34 years, but older women had lower trabecular vBMD (62.4 mg/cm3) than men (92.1 mg/cm3) at age 80 years. We show that LDCT-based opportunistic screening could identify large numbers of patients with low lumbar vBMD, and that future cohort studies are now required to evaluate the clinical utility of such screening in terms of fracture prevention and supporting national health economic analyses.
AB - Opportunistic screening for osteoporosis can be performed using low-dose computed tomography (LDCT) imaging obtained for other clinical indications. In this study we explored the CT-derived bone mineral density (BMD) and prevalence of osteoporosis from thoracic LDCT in a large population cohort of Chinese men and women. A total of 69,095 adults (40,733 men and 28,362 women) received a thoracic LDCT scan for the purpose of lung cancer screening between 2018 and 2019, and data were obtained for analysis from the China Biobank Project, a prospective nationwide multicenter population study. Lumbar spine (L1–L2) trabecular volumetric bone mineral density (vBMD) was derived from these scans using quantitative computed tomography (QCT) software and the American College of Radiology QCT diagnostic criteria for osteoporosis were applied. Geographic regional differences in the prevalence of osteoporosis were assessed and the age-standardized, population prevalence of osteoporosis in Chinese men and women was estimated from the 2010 China census. The prevalence of osteoporosis by QCT for the Chinese population aged >50 years was 29.0% for women and 13.5% for men, equating to 49.0 million and 22.8 million, respectively. In women, this rate is comparable to estimates from dual-energy X-ray absorptiometry (DXA), but in men, the prevalence is double. Prevalence varied geographically across China, with higher rates in the southwest and lower rates in the northeast. Trabecular vBMD decreased with age in both men and women. Women had higher peak trabecular vBMD (185.4 mg/cm3) than men (176.6 mg/cm3) at age 30 to 34 years, but older women had lower trabecular vBMD (62.4 mg/cm3) than men (92.1 mg/cm3) at age 80 years. We show that LDCT-based opportunistic screening could identify large numbers of patients with low lumbar vBMD, and that future cohort studies are now required to evaluate the clinical utility of such screening in terms of fracture prevention and supporting national health economic analyses.
KW - BONE MINERAL DENSITY
KW - LOW-DOSE CT
KW - OPPORTUNISTIC SCREENING
KW - OSTEOPOROSIS
KW - PREVALENCE
UR - http://www.scopus.com/inward/record.url?scp=85096745233&partnerID=8YFLogxK
U2 - 10.1002/jbmr.4187
DO - 10.1002/jbmr.4187
M3 - Article
C2 - 33145809
AN - SCOPUS:85096745233
SN - 0884-0431
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
ER -
