Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
J Clin Densitom. 2019 Jan-Mar;22(1):47-51. doi: 10.1016/j.jocd.2017.05.003. Epub 2017 Jun 19.
The mainstay of diagnosis of osteoporosis is dual-energy X-ray absorptiometry (DXA) scan measuring areal bone mineral density (BMD) (g/cm). The aim of the present study was to compare the Indian Council of Medical Research database (ICMRD) and the Lunar ethnic reference database of DXA scans in the diagnosis of osteoporosis in male patients. In this retrospective study, all male patients who underwent a DXA scan were included. The areal BMD (g/cm) was measured at either the lumbar spine (L1-L4) or the total hip using the Lunar DXA machine (software version 8.50) manufactured by GE Medical Systems (Shanghai, China). The Indian Council of Medical Research published a reference data for BMD in the Indian population derived from the population-based study conducted in healthy Indian individuals, which was used to analyze the BMD result by Lunar DXA scan. The 2 results were compared for various values using statistical software SPSS for Windows (version 16; SPSS Inc., Chicago, IL). A total 238 male patients with a mean age of 57.2 yr (standard deviation ±15.9) were included. Overall, 26.4% (66/250) and 2.8% (7/250) of the subjects were classified in the osteoporosis group according to the Lunar database and the ICMRD, respectively. Out of the 250 sites of the DXA scan, 28.8% (19/66) and 60.0% (40/66) of the cases classified as osteoporosis by the Lunar database were reclassified as normal and osteopenia by ICMRD, respectively. In conclusion, the Indian Council of Medical Research data underestimated the degree of osteoporosis in male subjects that might result in deferring of treatment. In view of the discrepancy, the decision on the treatment of osteoporosis should be based on the multiple fracture risk factors and less reliably on the BMD T-score.
骨质疏松症的主要诊断方法是双能 X 射线吸收法（DXA）扫描，测量面积骨矿物质密度（BMD）（g/cm）。本研究旨在比较印度医学研究理事会数据库（ICMRD）和 Lunar 族裔 DXA 扫描参考数据库在男性患者骨质疏松症诊断中的应用。在这项回顾性研究中，纳入了所有接受 DXA 扫描的男性患者。使用 Lunar DXA 机器（由上海通用电气医疗系统有限公司制造，软件版本 8.50）测量腰椎（L1-L4）或全髋关节的面积 BMD（g/cm）。印度医学研究理事会发布了一项基于人群的研究中印度人群的 BMD 参考数据，该研究在健康的印度个体中进行，该数据用于分析 Lunar DXA 扫描的 BMD 结果。使用 Windows 版 SPSS 统计软件（版本 16；芝加哥 SPSS 公司）比较了两种结果的各种值。共纳入 238 例平均年龄为 57.2 岁（标准差±15.9）的男性患者。总体而言，根据 Lunar 数据库和 ICMRD，分别有 26.4%（66/250）和 2.8%（7/250）的受试者被归类为骨质疏松症组。在 250 个 DXA 扫描部位中，根据 Lunar 数据库分类为骨质疏松症的 28.8%（19/66）和 60.0%（40/66）的病例分别被重新归类为 ICMRD 的正常和骨量减少。总之，印度医学研究理事会的数据低估了男性患者骨质疏松症的程度，这可能导致治疗延迟。鉴于这种差异，骨质疏松症的治疗决策应基于多重骨折风险因素，而不是更依赖于 BMD T 评分。
