Rochmis Paul G, Sheridan Michael J, Perry Leslie
Bone Densitometry Center, 3027 Javier Road, Fairfax, VA 22031-4607, USA.
J Clin Densitom. 2009 Apr-Jun;12(2):224-8. doi: 10.1016/j.jocd.2008.12.001. Epub 2009 Jan 31.
The results of dual-energy X-ray absorptiometry (DXA) testing frequently leads to a significant clinical treatment decision, based on T-score or Z-score results. Using the nearly universally accepted World Health Organization (WHO) criteria, which in turn are based on the validity of the population database, a flawed database may lead to an incorrect and deleterious clinical categorization. We have observed that the Hologic National Health and Nutrition Examination Survey III (NHANES III) femoral neck scores are frequently disproportionately low compared with scores in the other major hip regions and that the discordance is statistically significant. Although the WHO now uses the femoral neck T-score (in postmenopausal women and men 50 yr or older), many clinicians still use the lowest (worst) T-score in any 1 of 3 major scan regions--femoral neck, total hip, or lumbar spine--suggesting that patient misclassification may occur, leading to the potential for unnecessary pharmacologic intervention.
基于T值或Z值结果，双能X线吸收测定法（DXA）检测结果常常会导致重大的临床治疗决策。采用几乎被普遍接受的世界卫生组织（WHO）标准（该标准又基于人群数据库的有效性），有缺陷的数据库可能会导致错误且有害的临床分类。我们观察到，与其他主要髋关节区域的分数相比，Hologic国家健康与营养检查调查III（NHANES III）的股骨颈分数常常低得不成比例，且这种不一致具有统计学意义。尽管WHO现在使用股骨颈T值（用于绝经后女性和50岁及以上男性），但许多临床医生仍使用三个主要扫描区域（股骨颈、全髋或腰椎）中任何一个区域的最低（最差）T值，这表明可能会出现患者分类错误，从而导致不必要的药物干预。
