How does proximal femur BMD of healthy Irish adults compare to NHANES III? Results of the DXA-HIP Project

Erjiang, E; Wang, Tingyan; Yang, Lan; Dempsey, Mary; Brennan, Attracta; Yu, Ming; Chan, Wing P.; Whelan, Bryan; Silke, Charlotte; O’Sullivan, Miriam; Rooney, Bridie; McPartland, Aoife; O'Malley, G

doi:10.1007/s11657-021-01034-0

Cited by 4 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…( 23 , 24 , 43 ) The ISCD and International Osteoporosis Foundation currently recommend using the NHANES III proximal femur white female reference as the appropriate universal reference to calculate T ‐scores for the diagnosis of osteoporosis in older men and postmenopausal women using WHO criteria, ( 13 , 20 ) which show a similar age‐related pattern of proximal femur BMD to our population. ( 33 ) In 2016 our National Census demonstrated 1,446,460 Irish men and women aged ≥50 years, representing 30.4% of the population, though only preliminary data are currently available for 2022. ( 36 ) Based on these numbers, and our results, we estimate more than 1 million have low bone mass, and more than 300,000 have osteoporosis by DXA classification criteria.…”

Section: Discussionmentioning

confidence: 99%

“…( 34 ) Details of the data extraction, cleaning and analytic processes, and of the cohort, including demographics, risk factors, and treatments have been described. ( 30 , 31 , 32 , 33 , 35 ) We used NHANES III white female reference data to calculate T ‐scores at the femoral neck and total hip, and manufacturer USA/Northern Europe (GE Lunar) white female reference data to calculate lumbar spine and 1/3 radius T ‐scores. We chose the lowest T ‐score at either the lumbar spine, femoral neck, or total hip for diagnosis, as recommended by the ISCID.…”

Section: Methodsmentioning

confidence: 99%

“…( 30 ) We have previously shown that the prevalence of vertebral fractures increases with age in older men and women, ( 31 , 32 ) and that the international recommendation to use the Third National Health and Nutrition Examination Survey (NHANES III) white female reference data appears appropriate for our population. ( 33 ) In this work we compare the BMD and prevalence of low bone mass and osteoporosis among men and women referred for a DXA scan, between those without major risk factors or fracture, to those with major risk factors but without fractures, and those with major osteoporotic fractures.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Low Bone Mass and Osteoporosis in Ireland: the Dual‐Energy X‐Ray Absorptiometry (DXA) Health Informatics Prediction (HIP) Project

Carey

Erjiang²,

Wang

et al. 2023

JBMR Plus

Self Cite

View full text Add to dashboard Cite

Osteoporosis is a common disease that has a significant impact on patients, healthcare systems, and society. World Health Organization (WHO) diagnostic criteria for postmenopausal women were established in 1994 to diagnose low bone mass (osteopenia) and osteoporosis using dual‐energy X‐ray absorptiometry (DXA)‐measured bone mineral density (BMD) to help understand the epidemiology of osteoporosis, and identify those at risk for fracture. These criteria may also apply to men ≥50 years, perimenopausal women, and people of different ethnicity. The DXA Health Informatics Prediction (HIP) project is an established convenience cohort of more than 36,000 patients who had a DXA scan to explore the epidemiology of osteoporosis and its management in the Republic of Ireland where the prevalence of osteoporosis remains unknown. In this article we compare the prevalence of a DXA classification low bone mass (T‐score < −1.0) and of osteoporosis (T‐score ≤ −2.5) among adults aged ≥40 years without major risk factors or fractures, with one or more major risk factors, and with one or more major osteoporotic fractures. A total of 33,344 subjects met our study inclusion criteria, including 28,933 (86.8%) women; 9362 had no fractures or major risk factors, 14,932 had one or more major clinical risk factors, and 9050 had one or more major osteoporotic fractures. The prevalence of low bone mass and osteoporosis increased significantly with age overall. The prevalence of low bone mass and osteoporosis was significantly greater among men and women with major osteoporotic fractures than healthy controls or those with clinical risk factors. Applying our results to the national population census figure of 5,123,536 in 2022 we estimate between 1,039,348 and 1,240,807 men and women aged ≥50 years have low bone mass, whereas between 308,474 and 498,104 have osteoporosis. These data are important for the diagnosis of osteoporosis in clinical practice, and national policy to reduce the illness burden of osteoporosis. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of Low Bone Mass and Osteoporosis in Ireland: the Dual‐Energy X‐Ray Absorptiometry (DXA) Health Informatics Prediction (HIP) Project

Carey

Erjiang²,

Wang

et al. 2023

JBMR Plus

Self Cite

View full text Add to dashboard Cite

show abstract

“…Encore software version 17. Femoral neck T -scores for men and women are generated using NHANES III ISCD-recommended calculations [ 35 ]. All scans are performed and reported by staff trained to ISCD standards and recommendations.…”

Section: Methodsmentioning

confidence: 99%

Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX

Yang

Dempsey²,

Brennan³

et al. 2023

Arch Osteoporos

Self Cite

View full text Add to dashboard Cite

Summary Appropriate use of FRAX reduces the number of people requiring DXA scans, while contemporaneously determining those most at risk. We compared the results of FRAX with and without inclusion of BMD. It suggests clinicians to carefully consider the importance of BMD inclusion in fracture risk estimation or interpretation in individual patients. Purpose FRAX is a widely accepted tool to estimate the 10-year risk of hip and major osteoporotic fracture in adults. Prior calibration studies suggest this works similarly with or without the inclusion of bone mineral density (BMD). The purpose of the study is to compare within-subject differences between FRAX estimations derived using DXA and Web software with and without the inclusion of BMD. Method A convenience cohort was used for this cross-sectional study, consisting of 1254 men and women aged between 40 and 90 years who had a DXA scan and complete validated data available for analysis. FRAX 10-year estimations for hip and major osteoporotic fracture were calculated using DXA software (DXA-FRAX) and the Web tool (Web-FRAX), with and without BMD. Agreements between estimates within each individual subject were examined using Bland–Altman plots. We performed exploratory analyses of the characteristics of those with very discordant results. Results Overall median DXA-FRAX and Web-FRAX 10-year hip and major osteoporotic fracture risk estimations which include BMD are very similar: 2.9% vs. 2.8% and 11.0% vs. 11% respectively. However, both are significantly lower than those obtained without BMD: 4.9% and 14% respectively, P < 0.001. Within-subject differences between hip fracture estimates with and without BMD were < 3% in 57% of cases, between 3 and 6% in 19% of cases, and > 6% in 24% of cases, while for major osteoporotic fractures such differences are < 10% in 82% of cases, between 10 and 20% in 15% of cases, and > 20% in 3% of cases. Conclusions Although there is excellent agreement between the Web-FRAX and DXA-FRAX tools when BMD is incorporated, sometimes there are very large differences for individuals between results obtained with and without BMD. Clinicians should carefully consider the importance of BMD inclusion in FRAX estimations when assessing individual patients.

show abstract

Updated practice guideline for dual-energy X-ray absorptiometry (DXA)

Slart,

Punda,

Ali

et al. 2024

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

The introduction of dual-energy X-ray absorptiometry (DXA) technology in the 1980s revolutionized the diagnosis, management and monitoring of osteoporosis, providing a clinical tool which is now available worldwide. However, DXA measurements are influenced by many technical factors, including the quality control procedures for the instrument, positioning of the patient, and approach to analysis. Reporting of DXA results may be confounded by factors such as selection of reference ranges for T-scores and Z-scores, as well as inadequate knowledge of current standards for interpretation. These points are addressed at length in many international guidelines but are not always easily assimilated by practising clinicians and technicians. Our aim in this report is to identify key elements pertaining to the use of DXA in clinical practice, considering both technical and clinical aspects. Here, we discuss technical aspects of DXA procedures, approaches to interpretation and integration into clinical practice, and the use of non-bone mineral density measurements, such as a vertebral fracture assessment, in clinical risk assessment.

show abstract

How does proximal femur BMD of healthy Irish adults compare to NHANES III? Results of the DXA-HIP Project

Cited by 4 publications

References 24 publications

Prevalence of Low Bone Mass and Osteoporosis in Ireland: the Dual‐Energy X‐Ray Absorptiometry (DXA) Health Informatics Prediction (HIP) Project

Prevalence of Low Bone Mass and Osteoporosis in Ireland: the Dual‐Energy X‐Ray Absorptiometry (DXA) Health Informatics Prediction (HIP) Project

Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX

Updated practice guideline for dual-energy X-ray absorptiometry (DXA)

Contact Info

Product

Resources

About