Original Article

Osteoporosis International

, Volume 16, Issue 12, pp 1558-1564

Osteoporosis assessment by whole body region vs. site-specific DXA

  • L. Joseph MeltonIIIAffiliated withDivision of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of MedicineDivision of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine
  • , Anne C. LookerAffiliated withNational Center for Health Statistics, Centers for Disease Control and Prevention
  • , John A. ShepherdAffiliated withDepartment of Radiology, University of California at San Francisco
  • , Michael K. O’ConnorAffiliated withDivision of Physics and Nuclear Pharmacy, Department of Diagnostic Radiology, Mayo Clinic College of Medicine
  • , Sara J. AchenbachAffiliated withDivision of Biostatistics, Department of Health Sciences Research, Mayo Clinic College of Medicine
  • , B. Lawrence RiggsAffiliated withDivision of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine
  • , Sundeep KhoslaAffiliated withDivision of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine

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Abstract

The ability of regional data from whole body scans to provide an accurate assessment of site-specific BMD, osteoporosis prevalence and fracture risk has not been fully explored. To address these issues, we measured total body (TBBD) and site-specific BMD in an age-stratified population sample of 351 women (21–93 years) and 348 men (22–90 years). We found an excellent correlation between AP lumbar spine and total body lumbar spine subregion BMD (r 2=0.92), but weaker ones for total hip compared to pelvis region (r 2=0.72) or between total wrist and left arm subregion from the whole body scan (r 2=0.83). The error in estimating site-specific BMD from total body regions ranged from 4.3% (lumbar spine) to 11.2% (femoral neck) in women and from 4.9 to 11.1%, respectively, in men. Site-specific versus regional measurements at the lumbar spine and total hip/pelvis provided comparable overall estimates of osteoporosis prevalence, but disagreed on the status of individuals; measurements at whole body regions underestimated osteoporosis as assessed at the femoral neck or total wrist. All measurements were associated with a history of various fractures [age adjusted odds ratios (OR), 1.3 to 2.1 in women and 1.2 to 1.5 in men] and were generally interchangeable, but femoral neck BMD provided the best estimate of osteoporotic fracture risk in women (OR, 2.9; 95% CI, 1.7–5.0). Although there are strong correlations between BMD from dedicated scans of the hip, spine and distal forearm and corresponding regions on the whole body scan, the measurements provide somewhat different estimates of osteoporosis prevalence and fracture risk.

Keywords

Bone density Epidemiology Fractures Osteoporosis Prevalence