Vy Vu Pham Thao, Lu Yi-Chien, Griffith James F, Lin Ying Chin, Chan Chun-Hsiang, Carey John J, Chan Wing P
International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan.
National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, 632, Taiwan.
Arch Osteoporos. 2025 Sep 12;20(1):123. doi: 10.1007/s11657-025-01605-5.
Clinicians should consider baseline BMD, age, and sex when assessing osteoporosis risk. Women over 65 with severe osteopenia need close monitoring. Transition rates reached 10.7% at 2 years and 25.9% at 5 years. Routine retesting in low-risk individuals is unnecessary; rescreening should focus on older adults with moderate to severe osteopenia.
The transition rate to osteoporosis based on baseline dual-energy X-ray absorptiometry (DXA) derived bone mineral density (BMD) status in older Asians has not been previously determined. This study was designed to evaluate the rate of transition to osteoporosis in participants aged 50 years and older.
We reviewed 1781 consecutive participants (1211 postmenopausal women and 570 men; mean age, 61.17 ± 9.10 years), who underwent repeat BMD testing with a mean follow-up duration of 2.41 ± 1.20 years. Participants were stratified into four groups according to lowest T-score (proximal femora or lumbar spine): normal BMD (T-score of > - 1.00), mild osteopenia (- 1.01 to - 1.49), moderate osteopenia (- 1.50 to - 1.99), and severe osteopenia (- 2.00 to - 2.49). The transition rate to osteoporosis was assessed for follow-up interval periods of < 2 years and 2-5 years.
A total of 581 patients (32.62%) transitioned to osteoporosis during follow-up. The transition rate to osteoporosis was higher in women than men (23.5% vs. 11.1%, p < 0.001). Transition rates to osteoporosis from baseline normal BMD and the three osteopenia subgroups (mild, moderate, severe) over 2 to 5 years were 1.2%, 7.8%, 29.9%, and 45.9% for women and 0.8%, 5.4%, 14.8%, and 39.6% for men. Transition rates from baseline normal BMD and the three osteopenia subgroups up to 2 years were 0.0%, 3.7%, 7.7%, and 30.2%, respectively. Transition rates in each category were higher in women than men, except in the severe osteopenia group (p = 0.064). Overall transition rate to osteoporosis was 10.7% for participants up to 2 years and 25.9% for between 2 and 5 years.
This study highlights a significant correlation between osteopenia severity and an increased risk of developing osteoporosis, particularly in older women. Women aged over 65 with severe osteopenia require close monitoring.
临床医生在评估骨质疏松症风险时应考虑基线骨密度、年龄和性别。65岁以上患有严重骨质减少的女性需要密切监测。2年时的转化率达到10.7%，5年时达到25.9%。低风险个体无需常规重新检测；重新筛查应侧重于患有中度至重度骨质减少的老年人。
基于基线双能X线吸收法（DXA）得出的骨矿物质密度（BMD）状态，此前尚未确定老年亚洲人向骨质疏松症的转化率。本研究旨在评估50岁及以上参与者向骨质疏松症的转化率。
我们回顾了1781名连续参与者（1211名绝经后女性和570名男性；平均年龄61.17±9.10岁），他们接受了重复的骨密度检测，平均随访时间为2.41±1.20年。参与者根据最低T值（股骨近端或腰椎）分为四组：骨密度正常（T值＞-1.00）、轻度骨质减少（-1.01至-1.49）、中度骨质减少（-1.50至-1.99）和重度骨质减少（-2.00至-2.49）。评估了随访间隔期＜2年和2至5年时向骨质疏松症的转化率。
共有581名患者（32.62%）在随访期间转化为骨质疏松症。女性向骨质疏松症的转化率高于男性（23.5%对11.1%，p＜0.001）。2至5年期间，从基线骨密度正常和三个骨质减少亚组（轻度、中度、重度）向骨质疏松症的转化率，女性分别为1.2%、7.8%、29.9%和45.9%，男性分别为0.8%、5.4%、14.8%和39.6%。截至2年时，从基线骨密度正常和三个骨质减少亚组的转化率分别为0.0%、3.7%、7.7%和30.2%。除重度骨质减少组外（p=0.064），各分类中的转化率女性均高于男性。随访2年及以内的参与者向骨质疏松症的总体转化率为10.7%，2至5年期间为25.9%。
本研究强调了骨质减少严重程度与发生骨质疏松症风险增加之间的显著相关性，尤其是在老年女性中。65岁以上患有严重骨质减少的女性需要密切监测。
