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KMID : 1007320090150020087
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Journal of the Korean Society of Menopause
2009 Volume.15 No. 2 p.87 ~ p.92
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Difference in the Diagnosis of Osteoporosis in Elderly Postmenopausal Women According to WHO and the 2008 International Society for Clinical Densitometry Diagnostic Criteria
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Chung Soo-Ho
Lee Hae-Hyeog
Kim Tae-Hee
Ryu Ae-Li
Cha Sang-Heon
Lee Im-Soon
Bae Dong-Han
Choi Seung-Do
Park Hye-In
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Abstract
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Objectives: We evaluated the difference in the diagnosis of osteoporosis in elderly Korean postmenopausal women that visited our hospital according to the WHO diagnostic criteria and the 2008 International Society for Clinical Densitometry (ISCD) criteria.
Methods: We evaluated 301 elderly postmenopausal women, 65 years if age and above (mean: 70.2 years), from February 2001 to December 2007. We divided the women into four groups according to age. Bone mineral density (BMD) was measured using dual X-ray absorptiometry (DXA). Osteoporosis was defined according to the World Health Organization (WHO) criteria and the International Society for Clinical Densitometry (ISCD).
Results: When the WHO threshold for postmenopausal women was applied, the frequency of osteoporosis diagnosed was 37.9% at the lumbar spine, 10.3% at the femoral neck, and 69.8% in at least one of the evaluated sites. When the ISCD criteria were applied, the frequency of osteoporosis diagnosed was 38.9%, 16.0%, and 42.9%, respectively. The frequency of osteopenia diagnosed using the ISCD criteria and the WHO threshold was 45.8%, and 17.9% respectively.
Conclusion: The WHO criteria are by far less stringent than the ISCD criteria. The diagnosis of osteoporosis using ISCD criteria is so strict that patients may be under-treated. On the other hand, using the WHO criteria, they may be over-treated. Better diagnostic criteria are needed.
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KEYWORD
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Osteoporosis, WHO criteria, ISCD official positions, Bone mineral density
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