Ishikawa K, Ohta T
Division of Health Promotion, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku, Tokyo 162-8636, Japan.
Calcif Tissue Int. 1999 Aug;65(2):112-6. doi: 10.1007/s002239900666.
Nationwide data on bone mass were collected from 33,992 subjects who underwent screenings for osteoporosis at 65 health care centers in 11 prefectures in Japan. Reference values in Japanese women were evaluated by the four convenient methods frequently used for the screening of osteoporosis based on healthy subjects, defined by their medical history. In addition, the prevalence of low bone mass was estimated in subjects 40 years or older by the four methods. Compared with the young normal subjects aged 20-29 years old, bone mass decreased after 30, 40, and 50 year in the calcaneus by quantitative ultrasound densitometry, the radius by dual energy X-ray absorptiometry (DXA), and the metacarpus by computed X-ray densitometer and digital image processing. The prevalence of a T-score <-1 was relatively similar (45.6-65.5% in the fifth decade and 81.3-94.3% in sixth) in each decade among the four methods. However, the use of a T-score </=-2.5 resulted in a marked difference in the prevalence (5.2-23.5% in the fifth decade, and 18. 7-67.9% in the sixth) among the methods. The cutoff value of bone mass at a T-score -2.5 was greater than the lowest quintile value of the fifth decade in radial bone mineral density (BMD), between the lowest quintile values of the fifth and sixth decades in the two metacarpal methods, and less than the value of the sixth decade in the calcaneal Stiffness index.
在日本11个县的65个医疗保健中心,对33992名接受骨质疏松症筛查的受试者收集了全国范围的骨量数据。根据健康受试者的病史定义,采用常用于骨质疏松症筛查的四种简便方法对日本女性的参考值进行了评估。此外,还通过这四种方法对40岁及以上受试者的低骨量患病率进行了估计。与20 - 29岁的年轻正常受试者相比,通过定量超声骨密度仪测量跟骨、双能X线吸收法(DXA)测量桡骨、计算机X线骨密度仪和数字图像处理测量掌骨,骨量在30岁、40岁和50岁后下降。四种方法中,每个十年T值<-1的患病率相对相似(第五个十年为45.6 - 65.5%,第六个十年为81.3 - 94.3%)。然而,使用T值≤-2.5时,各方法间患病率存在显著差异(第五个十年为5.2 - 23.5%,第六个十年为18.7 - 67.9%)。在桡骨骨矿物质密度(BMD)中,T值为-2.5时的骨量临界值大于第五个十年的最低五分位数;在两种掌骨测量方法中,该临界值介于第五个十年和第六个十年的最低五分位数之间;在跟骨硬度指数中,该临界值小于第六个十年的值。