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Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status.

Abstract

This analysis examines lumbar spine bone mineral density (BMD) of US adults from NHANES 2005-2008 by age, sex, and race/ethnicity. Prevalence of low spine BMD and agreement between the prevalence of low BMD at the spine and femur neck in older adults are also assessed.

INTRODUCTION

Lumbar spine BMD data from a representative sample of the US population have not been previously available.

METHODS

We used data from the National Health and Nutrition Examination Survey 2005-2008 to examine demographic patterns in lumbar spine BMD among US adults age ≥20 years and the prevalence of low lumbar spine BMD in adults age ≥50 years. Agreement between the prevalence of low BMD at the femur neck and spine in older adults was also assessed. Dual-energy X-ray absorptiometry was used to measure lumbar spine and femur neck BMD. World Health Organization definitions were used to categorize skeletal status as normal, osteopenia, or osteoporosis.

RESULTS

Compared to non-Hispanic whites, non-Hispanic blacks had higher and Mexican Americans had lower lumbar spine BMD. Lumbar spine BMD declined with age in women, but not in men. Approximately 4.7 million (10%) older US women and 1 million (3%) older men had lumbar spine osteoporosis in 2005-2008. Roughly one third of them differed in skeletal status at the spine and hip but most were normal at one site and osteopenic at the other. Only 3-10%, depending on sex, had osteoporosis at one skeletal site but not at the other skeletal site. Between 76% and 87% with discordant skeletal status had lumbar spine T-scores within 1 unit of the category threshold.

CONCLUSIONS

These findings suggest that measuring either the femur neck or the lumbar spine will correctly classify the majority of individuals who present for care as osteoporotic or not.

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  • Authors+Show Affiliations

    ,

    National Center for Health Statistics, Centers for Disease Control and Prevention, Room 4310, 3311 Toledo Road, Hyattsville, MD 20782, USA. Alooker@cdc.gov

    , ,

    Source

    MeSH

    Absorptiometry, Photon
    Adult
    African Americans
    Aged
    Aging
    Bone Density
    Bone Diseases, Metabolic
    European Continental Ancestry Group
    Female
    Femur Neck
    Health Surveys
    Humans
    Lumbar Vertebrae
    Male
    Mexican Americans
    Middle Aged
    Osteoporosis
    Osteoporosis, Postmenopausal
    Prevalence
    Sex Characteristics
    United States
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    21720893

    Citation

    Looker, A C., et al. "Lumbar Spine Bone Mineral Density in US Adults: Demographic Patterns and Relationship With Femur Neck Skeletal Status." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 23, no. 4, 2012, pp. 1351-60.
    Looker AC, Melton LJ, Borrud LG, et al. Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status. Osteoporos Int. 2012;23(4):1351-60.
    Looker, A. C., Melton, L. J., Borrud, L. G., & Shepherd, J. A. (2012). Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 23(4), pp. 1351-60. doi:10.1007/s00198-011-1693-z.
    Looker AC, et al. Lumbar Spine Bone Mineral Density in US Adults: Demographic Patterns and Relationship With Femur Neck Skeletal Status. Osteoporos Int. 2012;23(4):1351-60. PubMed PMID: 21720893.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status. AU - Looker,A C, AU - Melton,L J,3rd AU - Borrud,L G, AU - Shepherd,J A, Y1 - 2011/07/01/ PY - 2011/03/31/received PY - 2011/06/01/accepted PY - 2011/7/2/entrez PY - 2011/7/2/pubmed PY - 2012/6/5/medline SP - 1351 EP - 60 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 23 IS - 4 N2 - UNLABELLED: This analysis examines lumbar spine bone mineral density (BMD) of US adults from NHANES 2005-2008 by age, sex, and race/ethnicity. Prevalence of low spine BMD and agreement between the prevalence of low BMD at the spine and femur neck in older adults are also assessed. INTRODUCTION: Lumbar spine BMD data from a representative sample of the US population have not been previously available. METHODS: We used data from the National Health and Nutrition Examination Survey 2005-2008 to examine demographic patterns in lumbar spine BMD among US adults age ≥20 years and the prevalence of low lumbar spine BMD in adults age ≥50 years. Agreement between the prevalence of low BMD at the femur neck and spine in older adults was also assessed. Dual-energy X-ray absorptiometry was used to measure lumbar spine and femur neck BMD. World Health Organization definitions were used to categorize skeletal status as normal, osteopenia, or osteoporosis. RESULTS: Compared to non-Hispanic whites, non-Hispanic blacks had higher and Mexican Americans had lower lumbar spine BMD. Lumbar spine BMD declined with age in women, but not in men. Approximately 4.7 million (10%) older US women and 1 million (3%) older men had lumbar spine osteoporosis in 2005-2008. Roughly one third of them differed in skeletal status at the spine and hip but most were normal at one site and osteopenic at the other. Only 3-10%, depending on sex, had osteoporosis at one skeletal site but not at the other skeletal site. Between 76% and 87% with discordant skeletal status had lumbar spine T-scores within 1 unit of the category threshold. CONCLUSIONS: These findings suggest that measuring either the femur neck or the lumbar spine will correctly classify the majority of individuals who present for care as osteoporotic or not. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/21720893/full_citation L2 - https://dx.doi.org/10.1007/s00198-011-1693-z DB - PRIME DP - Unbound Medicine ER -