Lee Kyung-Shik, Bae Su-Hyun, Lee Seung Hwa, Lee Jungun, Lee Dong Ryul
Department of Family Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.
Department of Family Medicine, Ajou University Hospital, Suwon, Korea.
J Korean Med Sci. 2014 Nov;29(11):1514-22. doi: 10.3346/jkms.2014.29.11.1514. Epub 2014 Nov 4.
This cross-sectional study was performed to investigate the reference values for bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and the prevalence of osteoporosis in the Korean population by applying domestic reference data. In total, 25,043 Korean adults ≥20 yr of age (11,792 men and 13,251 women) participated in the study. The BMDs of the total hip, femoral neck, and lumbar spine were measured by DXA (Discovery-W, Hologic Inc.), and subjects with a BMD - 2.5 standard deviations or lower than the mean BMD for young adults (20-29 yr old) were considered to have osteoporosis. When applying the new reference values determined in this study from Korean subjects, the overall prevalence of osteoporosis increased in men aged ≥50 yr compared with that provided by the DXA manufacturer from Japanese subjects (12.2% vs. 7.8%, P<0.001) and decreased in postmenopausal women aged ≥50 yr (32.9% vs. 38.7%, P<0.001). According to the findings of this study, use of the reference values provided by the DXA manufacturer has resulted in the underdiagnosis of osteoporosis in Korean men and the overdiagnosis of osteoporosis in Korean women. Our data will serve as valuable reference standards for the diagnosis and management for osteoporosis in the Korean population.
本横断面研究旨在通过应用国内参考数据,调查采用双能X线吸收法(DXA)测量的骨密度(BMD)参考值以及韩国人群中骨质疏松症的患病率。共有25043名年龄≥20岁的韩国成年人(11792名男性和13251名女性)参与了本研究。采用DXA(Discovery-W,Hologic公司)测量全髋、股骨颈和腰椎的骨密度,骨密度比年轻成年人(20 - 29岁)的平均骨密度低2.5个标准差或更低的受试者被视为患有骨质疏松症。当应用本研究中根据韩国受试者确定的新参考值时,≥50岁男性骨质疏松症的总体患病率与DXA制造商提供的日本受试者参考值相比有所增加(12.2%对7.8%,P<0.001),而≥50岁绝经后女性的患病率则有所下降(32.9%对38.7%,P<0.001)。根据本研究结果,使用DXA制造商提供的参考值导致韩国男性骨质疏松症诊断不足,而韩国女性骨质疏松症诊断过度。我们的数据将作为韩国人群骨质疏松症诊断和管理的宝贵参考标准。