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

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Abstract

Summary

This analysis examines lumbar spine bone mineral density (BMD) of US adults from NHANES 2005–2008 by age, sex, and race/ethnicity. Prevalence of low spine BMD and agreement between the prevalence of low BMD at the spine and femur neck in older adults are also assessed.

Introduction

Lumbar spine BMD data from a representative sample of the US population have not been previously available.

Methods

We used data from the National Health and Nutrition Examination Survey 2005–2008 to examine demographic patterns in lumbar spine BMD among US adults age ≥20 years and the prevalence of low lumbar spine BMD in adults age ≥50 years. Agreement between the prevalence of low BMD at the femur neck and spine in older adults was also assessed. Dual-energy X-ray absorptiometry was used to measure lumbar spine and femur neck BMD. World Health Organization definitions were used to categorize skeletal status as normal, osteopenia, or osteoporosis.

Results

Compared to non-Hispanic whites, non-Hispanic blacks had higher and Mexican Americans had lower lumbar spine BMD. Lumbar spine BMD declined with age in women, but not in men. Approximately 4.7 million (10%) older US women and 1 million (3%) older men had lumbar spine osteoporosis in 2005–2008. Roughly one third of them differed in skeletal status at the spine and hip but most were normal at one site and osteopenic at the other. Only 3–10%, depending on sex, had osteoporosis at one skeletal site but not at the other skeletal site. Between 76% and 87% with discordant skeletal status had lumbar spine T-scores within 1 unit of the category threshold.

Conclusions

These findings suggest that measuring either the femur neck or the lumbar spine will correctly classify the majority of individuals who present for care as osteoporotic or not.

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Conflicts of interest

None.

Author information

Authors and Affiliations

  1. National Center for Health Statistics, Centers for Disease Control and Prevention, Room 4310, 3311 Toledo Road, Hyattsville, MD, 20782, USA

    A. C. Looker & L. G. Borrud

  2. Division of Epidemiology, College of Medicine, Mayo Clinic, Rochester, MN, USA

    L. J. Melton III

  3. Department of Radiology, University of California San Francisco, San Francisco, CA, USA

    J. A. Shepherd

Authors
  1. A. C. Looker
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  2. L. J. Melton III
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  3. L. G. Borrud
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  4. J. A. Shepherd
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Corresponding author

Correspondence to A. C. Looker.

Additional information

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

Appendix

Appendix

Table 4 Mean BMD and SD of reference groups used to calculate T-scores
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Looker, A.C., Melton, L.J., Borrud, L.G. et al. Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status. Osteoporos Int 23, 1351–1360 (2012). https://doi.org/10.1007/s00198-011-1693-z

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  • DOI: https://doi.org/10.1007/s00198-011-1693-z

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