Fine-tuning the cutpoint T-score as an epidemiological index with high specificity for osteoporosis: methodological considerations for the Chinese population

Wáng, Yì Xiáng J.; Xiao, Ben-Heng; Su, Yachun; Leung, Jason C. S.; Lam, Patti; Kwok, Timothy

doi:10.21037/qims-21-845

Cited by 9 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The knowledge that the prevalence of all clinical osteoporotic fractures among elderly Chinese is no more than half of that of elderly Caucasians will have implications in defining the cutpoint T-score as an epidemiological index for osteoporosis (64).…”

Section: Comparatively Lower Ovf Prevalence Among Elderly Chinese Men and Womenmentioning

confidence: 99%

‘Healthier Chinese spine’: an update of osteoporotic fractures in men (MrOS) and in women (MsOS) Hong Kong spine radiograph studies

Wáng¹,

Deng²,

Griffith³

et al. 2022

Quant Imaging Med Surg

Self Cite

View full text Add to dashboard Cite

For the MrOS (Hong Kong) and MsOS (Hong Kong) baseline (BL) studies, community-dwelling 2,000 Chinese men (mean age: 72.3 years) and 2,000 Chinese women (mean age: 72.5 years) were recruited from 2001 to 2003. These two studies have spanned two decades till now. This review summarizes our spine radiograph results. Senile and post-menopausal osteoporosis were associated with intervertebral disc volume reduction; and in women, menopause accelerates disc degeneration. Elderly women's osteoporotic vertebral fracture (OVF) prevalence was double of that of elderly men. For year-4 follow-up (FU), male participants with BL OVF had little increased risk for further OVF. In our study comparing OVF rates in age-matched Hong Kong Chinese women and Italian Caucasian women (mean age: 74.1 years), endplate and/or cortex fracture (ECF) prevalence was 26% for Chinese and 47% for Italian. OVF with ≥40% vertebral height loss was recorded among 9.5% of the Chinese subjects while among 26% of the Italian subjects. OVFs in Italian subjects were more likely to be multiple and generally severer. Clinical spine fractures were recorded 133 cases/100,000 person-years in MrOS (Hong Kong) participants and 273 cases/100,000 person-years in MsOS (Hong Kong) participants. Literature review suggests the clinical vertebral fracture rates among elderly Hong Kong Chinese subjects are approximately half of those of American, Australian, and Canadian subjects. Data synthesis suggests elderly Caucasians have a higher degenerative spondylolisthesis prevalence, being approximately 70% higher than that of elderly Hong Kong Chinese. Literature review of other authors' publications shows, compared with Caucasians, Chinese have a much lower incident rate of back pain. We conclude that elderly Chinese have a generally healthier spine relative to elderly Caucasians.

show abstract

Section: Comparatively Lower Ovf Prevalence Among Elderly Chinese Men and Womenmentioning

confidence: 99%

‘Healthier Chinese spine’: an update of osteoporotic fractures in men (MrOS) and in women (MsOS) Hong Kong spine radiograph studies

Wáng¹,

Deng²,

Griffith³

et al. 2022

Quant Imaging Med Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…The cutpoint T-score for defining osteoporosis was initially proposed only for postmenopausal Caucasian women, which is related to the osteoporotic fracture prevalence of postmenopausal Caucasian women. We have recently argued that, in addition to using a local reference database, an additional adjustment of the cutpoint T-score for defining osteoporosis among older Chinese should be applied ( 50 ). If we assume Chinese women’s osteoporotic hip fracture prevalence is 40% of that of Caucasians and using the Hong Kong data of Lynn et al ( 51 ), in an earlier report we estimated that the cutpoint T-score for defining femoral neck osteoporosis can be better set at ≤–2.78.…”

mentioning

confidence: 99%

Estimations of bone mineral density defined osteoporosis prevalence and cutpoint T-score for defining osteoporosis among older Chinese population: a framework based on relative fragility fracture risks

Wáng¹,

Xiao²

2022

Quant Imaging Med Surg

Self Cite

View full text Add to dashboard Cite

The clinical significance of osteoporosis lies in the fractures which occur, and the most important fracture is hip fracture. According to the WHO criteria, T-score is defined as: (BMD patient -BMD young normal mean )/SD young normal population , where BMD is bone mineral density and SD is the standard deviation. In adult women, the cutpoint value of patient BMD 2.5 SD below BMD young normal mean satisfies that, when the femoral neck is measured, osteoporosis prevalence is about 16.2% for those aged ≥50 years, the same as the lifetime risk of hip fragility fracture (FF) (1,2). If other sites are also considered, this cutpoint value identifies approximately 30% of postmenopausal women as having osteoporosis, which is approximately equivalent to the lifetime risk of FF at the spine, hip, or forearm. It is commonly considered that this osteoporotic portion of the population has a faster bone mass loss, and interventions

show abstract

“…OLVF, osteoporotic-like vertebral fracture; OVF, osteoporotic vertebral fracture; BMD, bone mineral density. Recently we argued that due to the much lower fragility prevalence among older Chinese than among Caucasians, the criterion of tscore lowest threshold ≤−2.5 for defining osteoporosis may be too loose for Chinese (18)(19)(20). The comparative OLVFss analysis of Hong Kong Chinese women and Italian Caucasian women (Figures 9, 10,12) further supports our suggestion that tscore lumbar (lumbar spine T-score) threshold for defining osteoporosis should be less than <−3.7 for Hong Kong Chinese women (18).…”

Section: Ovf Severity and Bmd Among Older Womenmentioning

confidence: 99%

A summary of our recent evidence-based works on radiographic diagnostics of prevalent osteoporotic vertebral fracture in older men and women

Wáng¹

2023

Quant Imaging Med Surg

View full text Add to dashboard Cite

Fine-tuning the cutpoint T-score as an epidemiological index with high specificity for osteoporosis: methodological considerations for the Chinese population

Cited by 9 publications

References 10 publications

‘Healthier Chinese spine’: an update of osteoporotic fractures in men (MrOS) and in women (MsOS) Hong Kong spine radiograph studies

‘Healthier Chinese spine’: an update of osteoporotic fractures in men (MrOS) and in women (MsOS) Hong Kong spine radiograph studies

Estimations of bone mineral density defined osteoporosis prevalence and cutpoint T-score for defining osteoporosis among older Chinese population: a framework based on relative fragility fracture risks

A summary of our recent evidence-based works on radiographic diagnostics of prevalent osteoporotic vertebral fracture in older men and women

Contact Info

Product

Resources

About