Dual X-ray absorptiometry—cross-calibration and normative reference ranges for the spine: Results of a European Community Concerted Action

Dequeker, Jan; Pearson, J; Reeve, J.; Henley, Michael V.; Bright, J.E.; Felsenberg, Dieter; Kalender, Willi A.; Laval-Jeantet, A. M.; Rüegsegger, P.; Adams, Judith E.; Curiel, Manuel Dı́az; Fischer, M.; Galán, Fernando; Geusens, Piet; Hyldstrup, Lars; Jaeger, P; Kotzki, Pierre‐Olivier; Kröger, Heikki; Lips, Paul; Mitchell, Angela M.; Louis, Olivia; Cano, R. Pérez; Pols, Huibert A. P.; Reid, David M.; Ribot, C.; Schneider, Peter; Lunt, Mark

doi:10.1016/8756-3282(95)00224-2

Cited by 63 publications

(34 citation statements)

References 18 publications

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“…However for the women, while the difference between groups was not significant at the femoral neck or trochanter (mean differences 0.094 and 0.020 g/cm 2 , p = 0.49 and 0.11 respectively, n = 367), significant differences emerged at the L2-L4 spine measurement site (0.111 g/cm 2 p = 0.01, n = 390). Therefore, the primary report is on the population-based data.…”

Section: Resultsmentioning

confidence: 99%

“…For the men there was no significant effect of recruitment method, with the BMD difference between population-based vs. non-population based classifications being: femoral neck (-0.004 g/cm 2 , P = 0.32, n = 1320); trochanter (-0.018 g/cm 2 , P = 0.89, n = 1319) and L2-L4 spine (-0.011 g/cm 2 , P = 0.99, n = 1222). However for the women, while the difference between groups was not significant at the femoral neck or trochanter (mean differences 0.094 and 0.020 g/cm 2 , p = 0.49 and 0.11 respectively, n = 367), significant differences emerged at the L2-L4 spine measurement site (0.111 g/cm 2 p = 0.01, n = 390).…”

Section: Resultsmentioning

confidence: 99%

“…Because the three brands do not give the same results while expressing their BMD results in the units of g/cm 2 it was necessary to cross-calibrate them using the European Spine Phantom (ESP). This was done as described by Pearson et al [3], Kalender et al [5], and Lunt et al [6].…”

Section: Dxa Proceduresmentioning

confidence: 99%

“…The two multicentre studies were: a concerted action of the European Community's COMAC-BME FP2 programme (5 centres) [2,3] and the Polish EPOLOS osteoporosis study (6 centres). Principal investigators in Coimbra (Portugal), Ghent (Belgium), Kuopio (Finland), Prague (Czech Republic), and Odense (Denmark) contributed further population-based young normal BMD data.…”

Section: Introductionmentioning

confidence: 99%

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Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Kaptoge¹,

Silva²,

Brixen³

et al. 2008

Bone

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Edited by: Harry Genant Keywords:Bone mineral density (BMD) Dual energy X-ray absorptiometry (DXA) Europe T-score Osteoporosis Young normalWe collected population-based young normal hip and spine BMD data from 17 centres across Europe to assess between centre differences and to compare reference values with the US NHANES-III data. There was strong evidence of between country heterogeneity, but not between centres within countries. Hip BMD mean values were lower in European women, but SD's differed little from the NHANES-III USA results in both sexes. It may be necessary to adjust NHANES-III based T-scores by adding/subtracting a country-specific adjustment factor. Introduction: It remains unclear whether young normal BMD reference values specific to an American population can be validly used for T-score calculation in Europeans. Methods: We collected population based BMD data from 1163 men and 329 women aged 19-29 years from 17 centres across Europe to compare mean and SD values with the NHANES-III study USA results. BMD(g/cm 2 ) was measured at the hip and spine using DXA densitometers cross-calibrated with the European Spine Phantom (ESP). The only exclusions were for technically inadequate scans. A linear regression model was used to derive reference values. To allow for direct comparison with published NHANES III study data, the cross-calibrated BMD values were converted using the ESP equations to Hologic QDR 1000 units. Results: In men, the overall mean(SD) BMD values expressed in Hologic-QDR1000 units of measurement, were: femoral neck 0.912(0.132); trochanter 0.793(0.124); and L2-L4 spine 1.027(0.123). The respective estimates in women were: 0.826(0.115); 0.670(0.093); and 0.983(0.107). However the I 2 statistic for heterogeneity indicated moderate to strong evidence of between-centre heterogeneity. There was, however, no significant heterogeneity observed between centres within countries, suggesting that this variation arose from national differences. Compared to the NHANES III population-based US data, the mean values in women were significantly lower at both sites due to some lower national European means. However, at all sites and in both sexes the SD's were very similar between the US and Europe. There was some evidence that recruiting volunteers resulted in biased values in women. Conclusion: Our T-score normal values for the lumbar spine (L2-L4) should be more reliable for spine-specific risk assessment than some non-representative normal ranges, and should be evaluated for that purpose in Europe. If Tscores are to be used to compare individual data with ranges seen in normal young subjects of the same nationality, it may be necessary to adjust femoral NHANES III-based T-scores by adding (or subtracting) a country-specific adjustment factor. In risk assessment it is probably sufficient to use NHANES III-based hip T-scores, as supplied for the hip by densitometer manufacturers, interpreting them in light of recent international meta-analysis data on the relationship between BMD and fracture risk.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Dxa Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Kaptoge¹,

Silva²,

Brixen³

et al. 2008

Bone

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“…Quality control was ensured by daily calibration using the phantom provided by the manufacturer. Cross-calibration of instruments, allowing intercomparison of results obtained with machines from different manufacturers was performed using the European Spine Phantom prototype, according to the European Concerted Medical Action protocol (19).…”

Section: Bmd Measurementsmentioning

confidence: 99%

Influence of fluor salts, hormone replacement therapy and calcitonin on the concentration of insulin-like growth factor (IGF)-I, IGF-II and transforming growth factor-beta 1 in human iliac crest bone matrix from patients with primary osteoporosis

Seck²,

Diel³

et al. 2004

European Journal of Endocrinology

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Objective: Data from cell culture experiments suggest that local growth factors (GFs) may mediate the effects of estrogens, calcitonin or fluor ions on the skeleton. To assess the in vivo relevance of the in vitro reports, the effect of fluor salts, hormone replacement therapy (HRT) and calcitonin on the concentrations of IGF-I, IGF-II and transforming growth factor (TGF)-b1 in bone matrix extracts from osteoporotic patients was evaluated. Design: Iliac crest bone biopsies were obtained from 170 patients (76 men and 94 women) with primary osteoporosis aged 55.5^0.8 years. Methods: Bone matrix extraction was performed based on a guanidine -HCl/ethylendiamine -tetraacetic acid method. Results: In comparison with age-and body mass index (BMI)-matched controls, no influence of longterm therapy with fluor ions (n ¼ 41) or calcitonin (n ¼ 16) on the bone matrix concentration of GFs was noticed. Postmenopausal women with osteoporosis on HRT (n ¼ 39) had lower skeletal IGF-I but not IGF-II levels as compared with age-and BMI-matched non-users. However, the lower rate of bone turnover in women with HRT may account for this difference, since the significance was lost after adjustment for alkaline phosphatase. Likewise, a tendency for lower TGF-b1 levels was observed in HRT users as compared with non-users but was lost after adjustment for bone turnover. None of the therapies influenced the serum levels of GFs when patients receiving continuous therapy for at least 1 year before bone biopsy were considered. Conclusions: Our data suggest no direct effect of fluor therapy on skeletal GFs levels. At the concentrations used, neither HRT nor calcitonin appeared to exert any significant influence on serum or bone matrix GF levels.European Journal of Endocrinology 150 81-91

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Reduced bone mineral density and unbalanced bone metabolism in patients with inflammatory bowel disease

et al. 1998

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Patients with chronic inflammatory bowel diseases (IBD) are at increased risk to develop osteopenia and osteoporosis. New parameters for the assessment of bone formation and especially bone resorption have significantly improved the diagnostic procedures to characterize bone metabolism. Biochemical characterization of bone turnover in IBD patients may provide important information about the pathogenesis of osteoporosis in this patient population. A cross-sectional study was performed. One hundred forty-nine patients (77 men, 52 premenopausal, and 20 postmenopausal women) with IBD (104 with Crohn's disease [CD] and 45 with ulcerative colitis [UC]) underwent clinical, osteodensitometric, and metabolic bone assessment. Bone mineral density was determined by dual energy X-ray absorptiometry. Bone formation (bone alkaline phosphatase), bone resorption (N-terminal telopeptide of type-I collagen, free desoxypyridinoline, total pyridinoline, and desoxypyridinoline), vitamin D, and parathyroid hormone were assessed. Thirty-six percent of patients with CD and 32% with UC showed osteopenia, 15% with CD and 7% with UC showed osteoporosis. Bone resorption was significantly increased in IBD patients compared to normal controls, whereas bone formation did not show a compensatory increase. Bone formation was even more suppressed in the subset of patients currently treated with corticosteroids. Our data confirm the high prevalence of osteopenia and osteoporosis reported in IBD patients. Furthermore, we provide evidence for an increased bone resorption accompanied by low bone formation in IBD patients. This imbalance of bone metabolism is likely to be one of the reasons for increased bone loss in IBD patients.

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Dual X-ray absorptiometry—cross-calibration and normative reference ranges for the spine: Results of a European Community Concerted Action

Cited by 63 publications

References 18 publications

Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Geographical variation in DXA bone mineral density in young European men and women. Results from the Network in Europe on male osteoporosis (NEMO) study

Influence of fluor salts, hormone replacement therapy and calcitonin on the concentration of insulin-like growth factor (IGF)-I, IGF-II and transforming growth factor-beta 1 in human iliac crest bone matrix from patients with primary osteoporosis

Reduced bone mineral density and unbalanced bone metabolism in patients with inflammatory bowel disease

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