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Definition of a population-specific DXA reference standard in Italian women: the Densitometric Italian Normative Study (DINS)

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Abstract

Osteoporosis is currently defined on the basis of the T-score by dual-energy X-ray absorptiometry (DXA). Despite its limitations, this definition is applied worldwide. However, the normal values provided by manufacturers may not be fully representative of specific local populations. So far, there are no normative data in the Italian population using Hologic densitometers. The Densitometric Italian Normative Study (DINS) is an ongoing multi-center study that aims to establish reference values for bone densitometry with dual-energy X-ray absorptiometry (DXA) in the male and female Italian population. In this paper we report the results of the lumbar vertebrae (L2–L4) and proximal femur in 1,622 women aged 20–79 years. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry (DXA) on Hologic bone densitometers (Hologic, Waltham, Mass.). Most of the subjects were examined with a QDR 4500. The BMD of the lumbar vertebrae was virtually constant between 20 and 49 years (test for trend: P=0.66); the BMD values between 20–45 in premenopausal women (mean 1.036; SD 0.109 g/cm2) were thus defined as the peak bone mass values, significantly lower compared to the Hologic reference curve (mean 1.079, SD 0.11 g/cm2). The mean BMD values of the femoral neck were virtually identical to those of the NHANES study in the first 3 decades; after the age of 50 the BMD values were slightly greater than those of the NHANES subject. The subject classification according to the WHO criteria was similar using the DINS and NHANES reference values for the femur; for the spine, the Hologic reference values classified a larger proportion of women as osteoporotic (21 vs. 16%) or osteopenic (42 vs. 38%) compared to DINS.

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Article Open access 01 July 2023

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Authors and Affiliations

  1. Dipartimento di Medicina Interna e Scienze Biomediche, Università di Parma, Via Gramsci 14, 43100 , Parma, Italy

    M. Pedrazzoni

  2. Divisione di Reumatologia, Dipartimento Apparato Locomotore, ASL 3 Genovese, Genova, Italy

    G. Girasole & G. Bianchi

  3. Dipartimento di Scienze Biomediche e Chirurgiche, Università di Verona, Verona, Italy

    F. Bertoldo

  4. Dipartimento di Medicina Interna, Scienze Endocrino-Metaboliche e Biochimica, Università di Siena, Siena, Italy

    C. Cepollaro & S. Gonnelli

  5. Reumatologia, Università “Federico II”, Napoli, Italy

    A. Del Puente

  6. Dipartimento di Scienze Mediche e Chirurgiche, Università di Padova, Padova, Italy

    S. Giannini & L. Sartori

  7. Gerontologia e Geriatria, Università di Perugia, Perugia, Italy

    D. Maggio

  8. Dipartimento di Endocrinologia e Metabolismo, Università di Pisa, Pisa, Italy

    C. Marcocci

  9. Dipartimento di Scienze Cliniche, Università di Roma “La Sapienza”, Roma, Italy

    S. Minisola

  10. Dipartimento Interaziendale di Geriatria, ASL 3—Ospedali Galliera, Genova, Italy

    E. Palummeri

  11. Centro Osteoporosi, Università-ASL di Verona, Verona, Italy

    M. Rossini

  12. Servizio Malattie Osteometaboliche, Dipartimento di Reumatologia, Istituto G. Pini, Milano, Italy

    L. Sinigaglia

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  1. M. Pedrazzoni
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  2. G. Girasole
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  3. F. Bertoldo
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  4. G. Bianchi
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  5. C. Cepollaro
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  6. A. Del Puente
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  7. S. Giannini
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  8. S. Gonnelli
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  9. D. Maggio
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  10. C. Marcocci
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  11. S. Minisola
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  12. E. Palummeri
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  13. M. Rossini
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  14. L. Sartori
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  15. L. Sinigaglia
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Correspondence to M. Pedrazzoni.

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Pedrazzoni, M., Girasole, G., Bertoldo, F. et al. Definition of a population-specific DXA reference standard in Italian women: the Densitometric Italian Normative Study (DINS). Osteoporos Int 14, 978–982 (2003). https://doi.org/10.1007/s00198-003-1521-1

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  • DOI: https://doi.org/10.1007/s00198-003-1521-1

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