Department of Internal Medicine, No. 4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Department of Internal Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Chin Med J (Engl). 2019 Apr 5;132(7):772-781. doi: 10.1097/CM9.0000000000000143.
Areal bone mineral density (aBMD) applied for osteoporosis diagnosis unavoidably results in the missingdiagnosis in patients with large bones and misdiagnosis in those with small bones. Therefore, we try to find a new adjusted index of bone mineral content (BMC) to make up shortcomings of aBMD in osteoporosis diagnosis.
In this multi-center epidemiological study, BMC and aBMD of lumbar spines (n = 5510) and proximal femurs (n = 4710) were measured with dual energy X-ray absorptiometry (DXA). We analyzed the correlation between the bone mass and body weight in all subjects including four age groups (<19 years, 20-39 years, 40-49 years, >50 years). And then the body weight was used for standardizing BMC (named wBMC) and applied for the epidemiological analysis of osteoporosis.
The correlation of body weight and BMC is 0.839 to 0.931 of lumbar vertebra 1-4 (L1-4), and 0.71 to 0.95 of femoral neck in different age groups. When aBMD was applied for diagnosing osteoporosis, the prevalence was 7.55%, 16.39%, and 25.83% in patients with a high, intermediate, and low body weight respectively. However, the prevalence was 21.8%, 18.03%, and 11.64% by wBMC applied for diagnosing osteoporosis. Moreover, the prevalence of osteoporosis increased by 3.76% by wBMC with the body weight increased by 5 kg. The prevalence decreased by 1.94% when the body weight decreased by 5 kg.
wBMC can reduce the missed diagnosis in patients with large body weight and reduce misdiagnosis in those with small body weight. Including children, wBMC may be feasible for osteoporosis diagnosis individuals at any age.
应用于骨质疏松症诊断的骨面积密度（aBMD）不可避免地导致大骨患者漏诊和小骨患者误诊。因此，我们试图寻找新的骨矿物质含量（BMC）调整指数来弥补 aBMD 在骨质疏松症诊断中的不足。
在这项多中心的流行病学研究中，使用双能 X 射线吸收法（DXA）测量了腰椎（n=5510）和股骨近端（n=4710）的 BMC 和 aBMD。我们分析了所有受试者（包括四个年龄组<19 岁、20-39 岁、40-49 岁和>50 岁）的骨量与体重之间的相关性。然后，体重用于标准化 BMC（命名为 wBMC）并应用于骨质疏松症的流行病学分析。
不同年龄组腰椎 1-4（L1-4）和股骨颈的体重与 BMC 的相关性为 0.839 至 0.931，0.71 至 0.95。当应用 aBMD 诊断骨质疏松症时，高、中、低体重患者的患病率分别为 7.55%、16.39%和 25.83%。然而，应用 wBMC 诊断骨质疏松症时，患病率分别为 21.8%、18.03%和 11.64%。此外，wBMC 随着体重增加 5 公斤，骨质疏松症的患病率增加 3.76%。体重减轻 5 公斤时，患病率降低 1.94%。
wBMC 可以减少大体重患者的漏诊，减少小体重患者的误诊。包括儿童在内，wBMC 可能适用于任何年龄个体的骨质疏松症诊断。
