Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.
Osteoporos Int. 2011 Nov;22(11):2829-36. doi: 10.1007/s00198-010-1507-8. Epub 2011 Jan 27.
One thousand six hundred healthy subjects aged more than 50 years, residing in Delhi, were evaluated for bone mineral metabolic parameters. High prevalence of osteoporosis (35.1% subjects) was observed in this population. Bone mineral density (BMD) correlated positively with body mass index (BMI) and negatively with PTH levels. No correlation was observed with serum 25(OH)D levels.
To assess the bone health status in elderly Indians and compare peripheral DXA (pDXA) with central DXA in evaluation of osteoporosis.
The study involved 1,600 healthy subjects more than 50 years of age residing in Delhi, India, who underwent anthropometric, biochemical, and hormonal evaluation. BMD was measured by DXA at lumbar spine, hip, and distal radius; and by pDXA at forearm and calcaneum.
Seven hundred ninety-two males and 808 postmenopausal females, with a mean age of 57.67 ± 9.46 years were evaluated. Osteoporosis was present in 35.1% subjects (M-24.6%, F-42.5%) and osteopenia in 49.5% (M-54.3%, F-44.9%). Prevalence of osteoporosis increased with age in females, but not in males. BMD at all sites, except distal radius, was positively correlated with BMI (r=0.037, p=0.14). Total body BMD was negatively correlated with alkaline phosphatase (r= -0.184, p<0.00001) and PTH levels (r= -0.099, p<0.00001), respectively. No significant correlation was observed between serum 25(OH)D levels and BMD at any site. BMD at forearm and calcaneum, measured using pDXA, showed strong positive correlation with BMD measured by central DXA. pDXA had sensitivity of 88%, specificity of 55%, and negative and positive predictive values of 89% and 52%, respectively, at T-score -2.5 at peripheral sites compared to central DXA.
A high prevalence of osteoporosis was observed in elderly Indian subjects. pDXA has high negative predictive value, making it a useful tool in population screening for osteoporosis.
评估印度老年人的骨骼健康状况，并比较外周 DXA（pDXA）与中央 DXA 在骨质疏松评估中的作用。
这项研究纳入了 1600 名居住在印度德里的 50 岁以上的健康受试者，他们接受了人体测量学、生化和激素评估。通过 DXA 测量腰椎、髋部和远端桡骨的骨密度；通过 pDXA 测量前臂和跟骨的骨密度。
共评估了 792 名男性和 808 名绝经后女性，平均年龄为 57.67 ± 9.46 岁。骨质疏松症在 35.1%的受试者中存在（男性 24.6%，女性 42.5%），骨量减少症在 49.5%的受试者中存在（男性 54.3%，女性 44.9%）。女性各部位的骨质疏松症患病率随年龄增长而增加，但男性则不然。除了远端桡骨，所有部位的骨密度均与 BMI 呈正相关（r=0.037，p=0.14）。全身骨密度与碱性磷酸酶（r=-0.184，p<0.00001）和 PTH 水平（r=-0.099，p<0.00001）呈负相关。血清 25(OH)D 水平与任何部位的骨密度均无显著相关性。使用 pDXA 测量的前臂和跟骨骨密度与中央 DXA 测量的骨密度呈强正相关。与中央 DXA 相比，pDXA 在周边部位 T 评分-2.5 时，其灵敏度为 88%，特异性为 55%，阴性预测值为 89%，阳性预测值为 52%。
印度老年受试者中骨质疏松症的患病率较高。pDXA 具有较高的阴性预测值，是骨质疏松症人群筛查的有用工具。
