The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA

N. C. Wright, K. G. Saag, B. Dawson-Hughes, Sundeep Khosla, E. S. Siris

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Summary: We evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The expanded definition increases the prevalence compared to BMD alone definitions; however, it may better identify those at elevated fracture risk. Purpose: The purpose of this paper is to estimate the prevalence of osteoporosis in US adults ≥50 years using the NBHA osteoporosis diagnostic criteria. Methods: Utilizing 2005–2008 data of the National Health and Nutrition Examination Survey (NHANES), we identified participants with osteoporosis with any one of the following: (1) femoral neck or lumbar spine T-score ≤ −2.5; (2) low trauma hip fracture irrespective of BMD or clinical vertebral, proximal humerus, pelvis, or distal forearm fracture with a T-score >−2.5 <−1.0; or (3) FRAX score at the National Osteoporosis Foundation intervention thresholds (≥3% for hip fracture or ≥20% for major osteoporotic fracture). We estimated the prevalence overall and by gender and age. Results: Our sample included 1948 (54.3%) men and 1639 (45.7%) women. Approximately 12% were 80+ years and 21% were from racial/ethnic minority groups. We estimated that 16.0% (0.8) of men and 29.9% (1.0) of women 50+ years have osteoporosis. The prevalence increases with age to 46.3% in men and 77.1% in women 80+ years. The combination of FRAX score and fractures was the largest contributing factor defining osteoporosis in men (70–79, 88.1%; 80+, 80.1%), whereas T-score was the largest contributing factor in women (70–79, 49.2%; 80+, 43.5%). Conclusions: We found that 16% of men and 29.9% of women 50+ have osteoporosis based on the NBHA diagnostic criteria. Although the expanded definition increases the prevalence compared to BMD alone-based definitions, it may better identify those at elevated fracture risk in order to reduce the burden of fractures in older adults.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalOsteoporosis International
DOIs
StateAccepted/In press - Dec 13 2016

Fingerprint

Insurance Pools
Osteoporosis
Bone and Bones
Bone Density
Hip Fractures
Minority Groups
Osteoporotic Fractures
Nutrition Surveys
Femur Neck
Humerus
Pelvis
Ethnic Groups
Forearm
Spine

Keywords

  • Diagnostic criteria
  • Epidemiology
  • Fracture prevention
  • Fracture risk assessment
  • Osteoporosis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA. / Wright, N. C.; Saag, K. G.; Dawson-Hughes, B.; Khosla, Sundeep; Siris, E. S.

In: Osteoporosis International, 13.12.2016, p. 1-8.

Research output: Contribution to journalArticle

@article{f9d5e571112f49538577151ac9c27f14,
title = "The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA",
abstract = "Summary: We evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The expanded definition increases the prevalence compared to BMD alone definitions; however, it may better identify those at elevated fracture risk. Purpose: The purpose of this paper is to estimate the prevalence of osteoporosis in US adults ≥50 years using the NBHA osteoporosis diagnostic criteria. Methods: Utilizing 2005–2008 data of the National Health and Nutrition Examination Survey (NHANES), we identified participants with osteoporosis with any one of the following: (1) femoral neck or lumbar spine T-score ≤ −2.5; (2) low trauma hip fracture irrespective of BMD or clinical vertebral, proximal humerus, pelvis, or distal forearm fracture with a T-score >−2.5 <−1.0; or (3) FRAX score at the National Osteoporosis Foundation intervention thresholds (≥3{\%} for hip fracture or ≥20{\%} for major osteoporotic fracture). We estimated the prevalence overall and by gender and age. Results: Our sample included 1948 (54.3{\%}) men and 1639 (45.7{\%}) women. Approximately 12{\%} were 80+ years and 21{\%} were from racial/ethnic minority groups. We estimated that 16.0{\%} (0.8) of men and 29.9{\%} (1.0) of women 50+ years have osteoporosis. The prevalence increases with age to 46.3{\%} in men and 77.1{\%} in women 80+ years. The combination of FRAX score and fractures was the largest contributing factor defining osteoporosis in men (70–79, 88.1{\%}; 80+, 80.1{\%}), whereas T-score was the largest contributing factor in women (70–79, 49.2{\%}; 80+, 43.5{\%}). Conclusions: We found that 16{\%} of men and 29.9{\%} of women 50+ have osteoporosis based on the NBHA diagnostic criteria. Although the expanded definition increases the prevalence compared to BMD alone-based definitions, it may better identify those at elevated fracture risk in order to reduce the burden of fractures in older adults.",
keywords = "Diagnostic criteria, Epidemiology, Fracture prevention, Fracture risk assessment, Osteoporosis",
author = "Wright, {N. C.} and Saag, {K. G.} and B. Dawson-Hughes and Sundeep Khosla and Siris, {E. S.}",
year = "2016",
month = "12",
day = "13",
doi = "10.1007/s00198-016-3865-3",
language = "English (US)",
pages = "1--8",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",

}

TY - JOUR

T1 - The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA

AU - Wright, N. C.

AU - Saag, K. G.

AU - Dawson-Hughes, B.

AU - Khosla, Sundeep

AU - Siris, E. S.

PY - 2016/12/13

Y1 - 2016/12/13

N2 - Summary: We evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The expanded definition increases the prevalence compared to BMD alone definitions; however, it may better identify those at elevated fracture risk. Purpose: The purpose of this paper is to estimate the prevalence of osteoporosis in US adults ≥50 years using the NBHA osteoporosis diagnostic criteria. Methods: Utilizing 2005–2008 data of the National Health and Nutrition Examination Survey (NHANES), we identified participants with osteoporosis with any one of the following: (1) femoral neck or lumbar spine T-score ≤ −2.5; (2) low trauma hip fracture irrespective of BMD or clinical vertebral, proximal humerus, pelvis, or distal forearm fracture with a T-score >−2.5 <−1.0; or (3) FRAX score at the National Osteoporosis Foundation intervention thresholds (≥3% for hip fracture or ≥20% for major osteoporotic fracture). We estimated the prevalence overall and by gender and age. Results: Our sample included 1948 (54.3%) men and 1639 (45.7%) women. Approximately 12% were 80+ years and 21% were from racial/ethnic minority groups. We estimated that 16.0% (0.8) of men and 29.9% (1.0) of women 50+ years have osteoporosis. The prevalence increases with age to 46.3% in men and 77.1% in women 80+ years. The combination of FRAX score and fractures was the largest contributing factor defining osteoporosis in men (70–79, 88.1%; 80+, 80.1%), whereas T-score was the largest contributing factor in women (70–79, 49.2%; 80+, 43.5%). Conclusions: We found that 16% of men and 29.9% of women 50+ have osteoporosis based on the NBHA diagnostic criteria. Although the expanded definition increases the prevalence compared to BMD alone-based definitions, it may better identify those at elevated fracture risk in order to reduce the burden of fractures in older adults.

AB - Summary: We evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The expanded definition increases the prevalence compared to BMD alone definitions; however, it may better identify those at elevated fracture risk. Purpose: The purpose of this paper is to estimate the prevalence of osteoporosis in US adults ≥50 years using the NBHA osteoporosis diagnostic criteria. Methods: Utilizing 2005–2008 data of the National Health and Nutrition Examination Survey (NHANES), we identified participants with osteoporosis with any one of the following: (1) femoral neck or lumbar spine T-score ≤ −2.5; (2) low trauma hip fracture irrespective of BMD or clinical vertebral, proximal humerus, pelvis, or distal forearm fracture with a T-score >−2.5 <−1.0; or (3) FRAX score at the National Osteoporosis Foundation intervention thresholds (≥3% for hip fracture or ≥20% for major osteoporotic fracture). We estimated the prevalence overall and by gender and age. Results: Our sample included 1948 (54.3%) men and 1639 (45.7%) women. Approximately 12% were 80+ years and 21% were from racial/ethnic minority groups. We estimated that 16.0% (0.8) of men and 29.9% (1.0) of women 50+ years have osteoporosis. The prevalence increases with age to 46.3% in men and 77.1% in women 80+ years. The combination of FRAX score and fractures was the largest contributing factor defining osteoporosis in men (70–79, 88.1%; 80+, 80.1%), whereas T-score was the largest contributing factor in women (70–79, 49.2%; 80+, 43.5%). Conclusions: We found that 16% of men and 29.9% of women 50+ have osteoporosis based on the NBHA diagnostic criteria. Although the expanded definition increases the prevalence compared to BMD alone-based definitions, it may better identify those at elevated fracture risk in order to reduce the burden of fractures in older adults.

KW - Diagnostic criteria

KW - Epidemiology

KW - Fracture prevention

KW - Fracture risk assessment

KW - Osteoporosis

UR - http://www.scopus.com/inward/record.url?scp=85003905123&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85003905123&partnerID=8YFLogxK

U2 - 10.1007/s00198-016-3865-3

DO - 10.1007/s00198-016-3865-3

M3 - Article

C2 - 27966104

AN - SCOPUS:85003905123

SP - 1

EP - 8

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

ER -