Osteoporosis Research Center, Creighton University, Omaha, NE, USA.
J Clin Densitom. 2011 Oct-Dec;14(4):428-33. doi: 10.1016/j.jocd.2011.04.009. Epub 2011 Jul 1.
Discordances between hip and spine areal density T-score values are common and incompletely understood. In a cohort of 1157 postmenopausal women, discordances of greater than 10% occurred in 91%, with spine bone mineral density (BMD) T-scores significantly less negative than femoral neck (FN) T-scores (p<0.001). However, when T-scores based on bone mineral content (BMC) rather than BMD were used, the mean discordance was not significantly different from 0. This was largely because BMC at the FN had seemingly declined with age less rapidly than had BMD at that site. This can be explained by age-related areal expansion at the hip, which would be missed in the reported BMD output. One consequence is that if BMC-based T-scores are used to classify patients, substantially fewer individuals would have been judged osteoporotic in this cohort (two-thirds fewer for spine and three-fourths fewer for hip).
髋关节和脊柱骨密度 T 评分值之间的差异很常见，但尚未完全了解。在 1157 名绝经后妇女的队列中，91%的患者存在大于 10%的差异，脊柱骨密度（BMD）T 评分明显低于股骨颈（FN）T 评分（p<0.001）。然而，当使用基于骨矿物质含量（BMC）而不是 BMD 的 T 评分时，平均差异与 0 无显著差异。这在很大程度上是因为 FN 的 BMC 似乎随年龄增长而下降的速度比该部位的 BMD 慢。这可以通过髋关节的年龄相关面积扩张来解释，而这在报告的 BMD 结果中会被忽略。其结果是，如果使用基于 BMC 的 T 评分来对患者进行分类，那么在该队列中，被判定为骨质疏松症的患者数量会明显减少（脊柱减少三分之二，髋关节减少四分之三）。
