Does using lower limit of normal values enhance the ability of a single bone mineral density measure to predict fractures

• Published in: Osteoporosis international 2010-11, Vol.21 (11), p.1881-1888
• Main Authors: Wu, Q, Magnus, J. H, Rice, J. C, Lefante, J. J
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Adult; Aged; Aging - physiology; Biological and medical sciences; Body Weight - physiology; Bone density; Bone Density - physiology; classification; Comparative studies; Diagnosis; Diseases of the osteoarticular system; Endocrinology; Epidemiologic Methods; Female; Femur Neck - physiopathology; Fractures; Health risk assessment; Hip Joint - physiopathology; Humans; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); LLN; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Older people; Original Article; Orthopedics; Osteoarticular system. Muscles; Osteoporosis; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - epidemiology; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis. Osteomalacia. Paget disease; Osteoporotic Fractures - diagnosis; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; Osteoporotic Fractures - physiopathology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Reference Values; Rheumatology; T-score; Traumas. Diseases due to physical agents; Women; Young Adult
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-009-1160-2

Summary Using a single bone mineral density (BMD) measure, we demonstrated that the lower limit of normal (LLN) method is more consistent in predicting osteoporosis fractures than the T-score in white menopausal women from the Study of Osteoporosis Fracture (SOF). Introduction In order to circumvent the inconsistencies and limitations with using the T-score when defining osteoporosis, we propose using 95% LLN values derived from centered polynomial models using the NHANES III BMD measures. The main aim of this study was to compare the two methods in prediction of fracture and agreement in osteoporosis classification using cohort data. Methods We compared the fracture prediction ability of the two methods using a single BMD measurement in 4,948 white women aged 67-74 years in the SOF employing kappa statistics, sensitivity, and specificity. Results The T-score provided inconsistent osteoporosis classification (46.6%) across the five hip regions of interest (ROIs) and this was significantly (p