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KMID : 1120320230090010014
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Osteoporosis and Sarcopenia
2023 Volume.9 No. 1 p.14 ~ p.21
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Conversion of osteoporotic-like vertebral fracture severity score to osteoporosis T-score equivalent status: A framework study for older Chinese men
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Yi Xiang J. Wang
Jason C.S. Leung
Patti M.S. Lam
Timothy C.Y. Kwok
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Abstract
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Objectives: To define what portion of older community men with what severity of radiographic osteoporotic-like vertebral fracture (OLVF) correspond to what low T-score status.
Methods: There were 755 community Chinese men (age: 76.4 ± 6.7 years) with thoracic and lumbar spine radiographs, and hip and lumbar spine bone mineral density measures. For each vertebra in a subject, a score of 0, －0.5, －1, －1.5, －2, －2.5, and －3 was assigned for no OLVF or OLVF of <20%, ≥ 20 －25%, ≥2 5%－1/3, ≥ 1/3－40%, ≥ 40%－2/3, and ≥ 2/3 vertebral height loss, respectively. OLVFss was defined as the summed score of vertebrae T4 to L5. OLVFss and T-scores were ranked from the smallest to the largest values.
Results: OLVFss of －2, －2.5, －3, corresponded to a mean femoral neck T-score of －2.297 (range: －2.355~－ 2.247), －2.494 (range: －2.637~ －2.363), and －2.773 (range: －2.898~－2.643), a mean hip T-score of －2.311 (range: －2.420~－2.234), －2.572 (range: －2.708~－2.432), －2.911 (range: －3.134~－2.708), a mean lumbar spine T-score of －2.495 (range: －2.656~－2.403), －2.931 (range: －3.255~－2.664), and －3.369 (range: －3.525~－3.258). The Pearson correlation value of OLVFss and T-score of femoral neck, hip and lumbar spine was r ＝ 0.21, 0.26, and 0.22 (all P < 0.0001).
Conclusions: A single severe grade radiological OLVF (≥ 40% height loss) or OLVFss ≤ －2.5 suggest the subject is osteoporotic, and a single collapse grade (≥ 2/3 height loss) OLVF or OLVFss ≤ －3 meets osteoporosis diagnosis criterion. The results highlight the difficulty of diagnosing osteoporotic vertebral fractures among Chinese older men.
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KEYWORD
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Osteoporosis, Osteoporotic vertebral fracture, Bone mineral density, T-score, Spine
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