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KMID : 1039620220120020116
Korean Journal of Family Practice
2022 Volume.12 No. 2 p.116 ~ p.122
Body Measurement Factors Associated with Discordance in Diagnosis of Osteoporosis Using Spinal and Hip Bone Densitometry
Jo Min-So

Choi Hee-Jeong
Lee Mi-Young
Oh Han-Jin
Abstract
Background: Osteoporosis is diagnosed based on the lowest T-score at the L1?L4 lumbar spine and total hip bone mineral density (BMD). Occasionally, there is discordance in diagnosis of osteoporosis which is the presence of different categories of T-scores in two skeletal sites of an individual. We aimed to find the body measurement factors associated with discordance in diagnosing osteoporosis using spinal and total hip bone densitometry.

Methods: Data were gathered from 362 participants who had visited a Health Promotion Center. Variables were measured via body metering and dual energy x-ray absorptiometry (DXA) performed on L1?L4 lumbar spine and total hip BMD. Partial correlation analysis was performed to identify the variables related to spinal and hip BMD. Logistic regression analysis was performed to find the body measurement factors associated with discordance in diagnosing osteoporosis.

Results: The participants¡¯ mean age was 56.8¡¾10.7 years. Concordance of T-scores, minor discordance, and major discordance were present in 56.9%, 39.5%, and 3.6% of participants, respectively. After adjusting for age and sex, the odds ratio for the discordance in diagnosing osteoporosis was significantly higher in the 3rd and 4th quartiles of the waist-hip ratio (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.07?3.95; OR 2.13, 95% CI 1.09?4.14).

Conclusion: Even if the T-score of spinal BMD is within the normal or osteopenic range, it is necessary to measure and confirm hip BMD when the waisthip ratio is high.
KEYWORD
Bone Mineral Density, Osteoporosis, Diagnosis, Waist-Hip Ratio, Body Mass Index
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