Effects of body size and skeletal site on the estimated prevalence of osteoporosis in women and men

L. J. Melton, Sundeep Khosla, S. J. Achenbach, M. K. O'Connor, W. M. O'Fallon, B. L. Riggs

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

There is growing awareness that therapeutic decision-making may be confounded by discrepancies in the prevalence of osteoporosis by World Health Organization criteria when bone density is measured at different skeletal sites. To explore this issue, we measured bone density at a variety of skeletal sites in a population-based sample of 348 men (age 22-90 years) and 351 women (age 21-93 years). Men had greater areal bone mineral density (BMD, g/cm2) than women at almost every subregion on total body, anteroposterior (AP) and lateral lumbar spine, proximal femur and forearm scans by dual-energy X-ray absorptiometry. However, adjustment for height or, where possible, calculation of bone mineral apparent density (BMAD, g/cm3) reduced or eliminated these differences. In addition, three different patterns of change in bone density over life were observed at the various skeletal sites as judged from cross-sectional data: no apparent age-related bone loss (e.g., AP spine BMD in men); linear bone loss over life in both sexes beginning in young adulthood (e.g., femoral neck BMD); and bone loss beginning around the time of menopause or a comparable age in men (e.g., midradius BMD). The various adjustments for bone size and the different patterns of age-related change in bone density had profound effects on the estimated prevalence of osteoporosis by World Health Organization criteria, which ranged from 2% to 45% among postmenopausal women and from 0 to 36% among men 50 years of age and older depending upon the skeletal parameter that was assessed. These observations emphasize the difficulties involved in attempts to standardize BMD scores and definitions of osteoporosis for clinical use.

Original languageEnglish (US)
Pages (from-to)977-983
Number of pages7
JournalOsteoporosis International
Volume11
Issue number11
DOIs
StatePublished - 2000

Fingerprint

Body Size
Bone Density
Osteoporosis
Bone and Bones
Spine
Femur Neck
Photon Absorptiometry
Menopause
Forearm
Femur
Decision Making
Population

Keywords

  • Aging
  • Bone density
  • Epidemiology
  • Gender
  • Osteoporosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of body size and skeletal site on the estimated prevalence of osteoporosis in women and men. / Melton, L. J.; Khosla, Sundeep; Achenbach, S. J.; O'Connor, M. K.; O'Fallon, W. M.; Riggs, B. L.

In: Osteoporosis International, Vol. 11, No. 11, 2000, p. 977-983.

Research output: Contribution to journalArticle

Melton, L. J. ; Khosla, Sundeep ; Achenbach, S. J. ; O'Connor, M. K. ; O'Fallon, W. M. ; Riggs, B. L. / Effects of body size and skeletal site on the estimated prevalence of osteoporosis in women and men. In: Osteoporosis International. 2000 ; Vol. 11, No. 11. pp. 977-983.
@article{bc090c83fc2d4c308670a5e49abd4047,
title = "Effects of body size and skeletal site on the estimated prevalence of osteoporosis in women and men",
abstract = "There is growing awareness that therapeutic decision-making may be confounded by discrepancies in the prevalence of osteoporosis by World Health Organization criteria when bone density is measured at different skeletal sites. To explore this issue, we measured bone density at a variety of skeletal sites in a population-based sample of 348 men (age 22-90 years) and 351 women (age 21-93 years). Men had greater areal bone mineral density (BMD, g/cm2) than women at almost every subregion on total body, anteroposterior (AP) and lateral lumbar spine, proximal femur and forearm scans by dual-energy X-ray absorptiometry. However, adjustment for height or, where possible, calculation of bone mineral apparent density (BMAD, g/cm3) reduced or eliminated these differences. In addition, three different patterns of change in bone density over life were observed at the various skeletal sites as judged from cross-sectional data: no apparent age-related bone loss (e.g., AP spine BMD in men); linear bone loss over life in both sexes beginning in young adulthood (e.g., femoral neck BMD); and bone loss beginning around the time of menopause or a comparable age in men (e.g., midradius BMD). The various adjustments for bone size and the different patterns of age-related change in bone density had profound effects on the estimated prevalence of osteoporosis by World Health Organization criteria, which ranged from 2{\%} to 45{\%} among postmenopausal women and from 0 to 36{\%} among men 50 years of age and older depending upon the skeletal parameter that was assessed. These observations emphasize the difficulties involved in attempts to standardize BMD scores and definitions of osteoporosis for clinical use.",
keywords = "Aging, Bone density, Epidemiology, Gender, Osteoporosis",
author = "Melton, {L. J.} and Sundeep Khosla and Achenbach, {S. J.} and O'Connor, {M. K.} and O'Fallon, {W. M.} and Riggs, {B. L.}",
year = "2000",
doi = "10.1007/s001980070037",
language = "English (US)",
volume = "11",
pages = "977--983",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "11",

}

TY - JOUR

T1 - Effects of body size and skeletal site on the estimated prevalence of osteoporosis in women and men

AU - Melton, L. J.

AU - Khosla, Sundeep

AU - Achenbach, S. J.

AU - O'Connor, M. K.

AU - O'Fallon, W. M.

AU - Riggs, B. L.

PY - 2000

Y1 - 2000

N2 - There is growing awareness that therapeutic decision-making may be confounded by discrepancies in the prevalence of osteoporosis by World Health Organization criteria when bone density is measured at different skeletal sites. To explore this issue, we measured bone density at a variety of skeletal sites in a population-based sample of 348 men (age 22-90 years) and 351 women (age 21-93 years). Men had greater areal bone mineral density (BMD, g/cm2) than women at almost every subregion on total body, anteroposterior (AP) and lateral lumbar spine, proximal femur and forearm scans by dual-energy X-ray absorptiometry. However, adjustment for height or, where possible, calculation of bone mineral apparent density (BMAD, g/cm3) reduced or eliminated these differences. In addition, three different patterns of change in bone density over life were observed at the various skeletal sites as judged from cross-sectional data: no apparent age-related bone loss (e.g., AP spine BMD in men); linear bone loss over life in both sexes beginning in young adulthood (e.g., femoral neck BMD); and bone loss beginning around the time of menopause or a comparable age in men (e.g., midradius BMD). The various adjustments for bone size and the different patterns of age-related change in bone density had profound effects on the estimated prevalence of osteoporosis by World Health Organization criteria, which ranged from 2% to 45% among postmenopausal women and from 0 to 36% among men 50 years of age and older depending upon the skeletal parameter that was assessed. These observations emphasize the difficulties involved in attempts to standardize BMD scores and definitions of osteoporosis for clinical use.

AB - There is growing awareness that therapeutic decision-making may be confounded by discrepancies in the prevalence of osteoporosis by World Health Organization criteria when bone density is measured at different skeletal sites. To explore this issue, we measured bone density at a variety of skeletal sites in a population-based sample of 348 men (age 22-90 years) and 351 women (age 21-93 years). Men had greater areal bone mineral density (BMD, g/cm2) than women at almost every subregion on total body, anteroposterior (AP) and lateral lumbar spine, proximal femur and forearm scans by dual-energy X-ray absorptiometry. However, adjustment for height or, where possible, calculation of bone mineral apparent density (BMAD, g/cm3) reduced or eliminated these differences. In addition, three different patterns of change in bone density over life were observed at the various skeletal sites as judged from cross-sectional data: no apparent age-related bone loss (e.g., AP spine BMD in men); linear bone loss over life in both sexes beginning in young adulthood (e.g., femoral neck BMD); and bone loss beginning around the time of menopause or a comparable age in men (e.g., midradius BMD). The various adjustments for bone size and the different patterns of age-related change in bone density had profound effects on the estimated prevalence of osteoporosis by World Health Organization criteria, which ranged from 2% to 45% among postmenopausal women and from 0 to 36% among men 50 years of age and older depending upon the skeletal parameter that was assessed. These observations emphasize the difficulties involved in attempts to standardize BMD scores and definitions of osteoporosis for clinical use.

KW - Aging

KW - Bone density

KW - Epidemiology

KW - Gender

KW - Osteoporosis

UR - http://www.scopus.com/inward/record.url?scp=0034517558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034517558&partnerID=8YFLogxK

U2 - 10.1007/s001980070037

DO - 10.1007/s001980070037

M3 - Article

C2 - 11193251

AN - SCOPUS:0034517558

VL - 11

SP - 977

EP - 983

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

IS - 11

ER -