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Different reference BMDs affect the prevalence of osteoporosis

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Abstract

The T score represents the degree of deviation from the peak bone mineral density (BMD) (reference standard) in a population. Little has been investigated concerning the age at which the BMD reaches the peak value and how we should define the reference standard BMD in terms of age ranges. BMDs of 9,800 participants were analyzed from the Korean National Health and Nutrition Examination Survey database. Five reference standards were defined: (1) the reference standard of Japanese young adults provided by the dual-energy X-ray absorptiometry machine manufacturer, (2) peak BMD of the Korean population evaluated by statistical analysis (second-order polynomial regression models), (3) BMD of subjects aged 20–29 years, (4) BMD of subjects aged 20–39 years, and (5) BMD of subjects aged 30–39 years. T-scores from the five reference standards were calculated, and the prevalence of osteoporosis was evaluated and compared for males and females separately. The peak BMD in the polynomial regression model was achieved at 26 years in males and 36 years in females in the total hip, at 20 years in males and 27 years in females in the femoral neck, and at 20 years in males and 30 years in females in the lumbar spine. The prevalence of osteoporosis over the age of 50 years showed significant variation of up to two fold depending on the reference standards adopted. The age at which peak BMD was achieved was variable according to the gender and body sites. A consistent definition of peak BMD needs to be established in terms of age ranges because this could affect the prevalence of osteoporosis and healthcare policies.

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Acknowledgments

This research was supported by the Ministry of Trade, Industry and Energy of Korea (grant nos. 10045220 and 10049711).

Conflict of interest

All authors have no conflicts of interest to declare.

Ethical standards

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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    Authors and Affiliations

    1. Department of Orthopaedic Surgery, Soonchunhyang University Cheonan Hospital, 23-20 Byeongmyeong-Dong, Dongnam-Gu, Cheonan, Chungcheongnam-Do, 330-721, Korea

      Ki Jin Jung

    2. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Seongnam, Kyeonggi-do, 463-707, Korea

      Chin Youb Chung, Moon Seok Park, Ka Hyun Kim & Kyoung Min Lee

    3. Department of Biomedical Research Institute, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Seongnam, Kyeonggi-do, Korea

      Soon-Sun Kwon

    4. Department of Orthopaedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, 77 Sakju-Ro, Chuncheon-Si, Gangwon-Do, 200-704, Korea

      Sang Young Moon

    5. Department of Orthopaedic Surgery, Sungkyunkwan University Samsung Changwon Hospital, 158, Palyoung-Ro, MasanHoiwon-Gu, Changwon, Gyeongnam-Do, 630-522, Korea

      In Hyeok Lee

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    1. Ki Jin Jung
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    2. Chin Youb Chung
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    3. Moon Seok Park
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    8. Kyoung Min Lee
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    Correspondence to Kyoung Min Lee.

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    K. J. Jung and C. Y. Chung contributed equally to this work.

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    Jung, K.J., Chung, C.Y., Park, M.S. et al. Different reference BMDs affect the prevalence of osteoporosis. J Bone Miner Metab 34, 347–353 (2016). https://doi.org/10.1007/s00774-015-0676-0

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    • DOI: https://doi.org/10.1007/s00774-015-0676-0

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