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Zhu K, Hunter M, Stuckey BGA, Walsh JP. Establishing a Total Hip T-Score Threshold to Measure Contralateral Hip Bone Mineral Density: Avoiding Missed Diagnosis of Osteoporosis. J Clin Densitom 2022; 25:577-586. [PMID: 35606279 DOI: 10.1016/j.jocd.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/07/2022] [Accepted: 04/24/2022] [Indexed: 10/18/2022]
Abstract
Bone mineral density (BMD) of the hip is routinely measured unilaterally, but can differ between left and right. This study aimed to establish total hip T-score thresholds for measuring contralateral hip BMD, to avoid missing the diagnosis of osteoporosis. In 4914 participants (2709 females) in the Busselton Healthy Ageing Study, BMD of both hips and lumbar spine (L1-L4) was measured by dual-energy x-ray absorptiometry (DXA) using a GE Lunar Prodigy Pro densitometer. Least significant change (LSC) was calculated according to International Society for Clinical Densitometry recommendations. For participants whose left-right total hip BMD difference exceeded LSC, the 95th percentile of the difference in T-score was calculated, then added to -2.5 (the cut-off for osteoporosis) to derive T-score thresholds for measuring contralateral hip to avoid a missed diagnosis in 95% of individuals. Participant mean age (±SD) was 57.4 ± 5.8 years; total hip T-score was 0.7 ± 0.1 in males and -0.2 ± 1.1 in females. Left and right total hip BMD were highly correlated (r = 0.943 for males, 0.959 for females), but in 56.2% of males and 50.0% of females, the left-right difference exceeded the LSC of 0.026 g/cm2. In these participants, the 95th percentile of difference in T-score between two hips was 0.872 in males and 0.742 in females. This gave T-score thresholds for measuring contralateral total hip BMD of -1.6 (males) and -1.8 (females). When total hip T-score is between -1.6 and -2.5 (males), or between -1.8 and -2.5 (females), measuring contralateral hip BMD could avoid a missed diagnosis of osteoporosis.
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Affiliation(s)
- Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia.
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia; Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
| | - Bronwyn G A Stuckey
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia; Keogh Institute for Medical Research, Nedlands, Western Australia, Australia
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Medical School, University of Western Australia, Crawley, Western Australia, Australia
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van Santen JA, Pereira C, Sanchez-Santos MT, Cooper C, Arden NK. Dominant vs. non-dominant hip comparison in bone mineral density in young sporting athletes. Arch Osteoporos 2019; 14:54. [PMID: 31129723 PMCID: PMC6535155 DOI: 10.1007/s11657-019-0605-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 05/06/2019] [Indexed: 02/03/2023]
Abstract
To explore differences in bone mineral density (BMD) between dominant and non-dominant hip within levels of sport impact. BMD was higher in the non-dominant hip in high-impact sports, whereas the dominant hip had increased BMD for low-impact sports. The side-to-side differences were relatively small and not clinically relevant. PURPOSE It is unknown whether there is difference in BMD at the hip between dominant and non-dominant sides in young athletes. The aims of this study were to explore the dominant-non-dominant differences in hip BMD in young athletes participating in low- and high-impact sports and to assess the effect of ground force impact on BMD. METHODS Data was collected on University of Oxford athletes and controls (CG) between 2016 and 2018. Athletes were classified into two groups: high-impact sports (HIG) and low-impact sports (LIG). Total and regional measurements of both hips' BMD were recorded using a dual-energy X-ray absorptiometry (DXA). Linear regression method was used to assess differences in BMD between and within groups. RESULTS One hundred ninety-four athletes (HIG: n = 89, LIG: n = 105) and 48 controls were included in this study. Total hip and femoral neck BMD was higher in athletes compared to the CG (p < 0.01), with HIG recording highest levels of BMD. The BMD difference between the dominant and non-dominant sides was significant in the LIG, with BMD being higher in the dominant side. Conversly, BMD was higher in the non-dominant hip within the HIG. However, the hip asymmetries were not clinically relevant (%BMD difference < 3%). A significant interaction between side and sport group on BMD was observed. CONCLUSIONS High-impact sports had significantly higher BMD compared with low-impact sports and CG. BMD in the dominant hip was significantly higher for the LIG and lower in the HIG; however, differences were not clinically relevant.
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Affiliation(s)
- James A van Santen
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, UK.
| | - Claudio Pereira
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, UK
| | - Maria T Sanchez-Santos
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, UK
| | - Cyrus Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, UK
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Nigel K Arden
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, Oxford, OX3 7LD, UK
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
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Lo HC, Kuo DP, Chen YL. Impact of beverage consumption, age, and site dependency on dual energy X-ray absorptiometry (DEXA) measurements in perimenopausal women: a prospective study. Arch Med Sci 2017; 13:1178-1187. [PMID: 28883860 PMCID: PMC5575220 DOI: 10.5114/aoms.2017.66033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/18/2015] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The aim of this study was to determine the best site for bone mineral density (BMD) measurements based on T-scores, age, and beverage consumption. MATERIAL AND METHODS In this prospective study, 271 women stratified by age (average age: 61.9 years) underwent dual energy X-ray absorptiometry (DEXA) scanning of their lumbar spine, hips, and forearms. Osteoporosis was defined as a BMD of 2.5 standard deviations or more below the mean peak bone mass based on a reference population of adult women (translated as a T-score ≤ -2.5), as measured by DEXA. Participants were also evaluated regarding alcohol and caffeine consumption by a semiquantitative questionnaire. RESULTS A significant discrepancy was observed in the classification of osteoporosis at different locations, with hip and forearm showing the best correlation (Pearson's r = 0.627, p < 0.001). In addition, for participants over 50 years of age, hip and forearm showed the best correlation. Significant correlations were also noted between forearm T-scores and caffeine consumed and, to a lesser extent, the level of alcohol consumption. In the group ≤ 50 years of age, lumbar spine and forearm T-scores were only associated with alcohol consumption. In the group over 50 years of age, hip and forearm T-scores were only associated with caffeine consumption. CONCLUSIONS Bone mineral density measurements at the hip and forearm correlated with caffeine consumption in elderly Taiwanese women. This is an important finding since age and caffeine consumption are known risk factors for osteoporosis.
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Affiliation(s)
- Huan-Chu Lo
- Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, China
- Department of Diagnostic Radiology, National Defense Medical Center, Triservice General Hospital, Taipei, Taiwan, China
- Department of Radiology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Duen-Pang Kuo
- Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, China
| | - Yen-Lin Chen
- Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, China
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