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Bone mineral density measurement combined with vertebral fracture assessment increases diagnosis of osteoporosis in postmenopausal women

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Abstract

Objective

Osteoporosis is diagnosed based on the results of BMD assessment and/or fragility fractures. Vertebral fracture is the most common fragility fracture. Many vertebral fractures are asymptomatic and are not clinically recognized. Early detection of vertebral fracture may increase diagnosis of osteoporosis. In this study, we performed BMD measurement combined with vertebral fracture assessment (VFA) by DXA for the postmenopausal women receiving the first bone densitometry and studied the impact of VFA on the diagnosis of osteoporosis.

Methods

A total of 502 postmenopausal women were enrolled in our study. Patients’ age was 66.7 ± 9.5 years. All patients had BMD assessment and VFA by dual-energy X-ray absorptiometry. Genant’s semiquantitative assessment was used. The impact of VFA on the diagnosis of osteoporosis was studied. All parameters of groups were compared using the Chi-squared test.

Results

There were 257 patients with T-score ≤−2.5, 202 patients with a T-score between −1 and − 2.5, and 43 patients with BMD within the normal range. There were 162 patients with 345 fractured vertebrae identified by VFA, among which 84% of patients were previously unknown. Osteoporosis or severe osteoporosis was presented in 51.2% patients diagnosed by BMD alone, in 55.2% patients diagnosed by BMD plus fracture history, and in 62.4% of patients diagnosed by BMD plus fracture history and VFA. Severe osteoporosis significantly increased by 17.2% in patients receiving VFA.

Conclusions

VFA combined with BMD can detect previously unknown vertebral fractures and increase clinical diagnosis of osteoporosis. It is plausible to speculate that this method should be considered in postmenopausal women for the first BMD assessment.

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Abbreviations

BMD:

Bone mineral density

DXA:

Dual-energy X-ray absorptiometry

VFA:

Vertebral fracture assessment

ISCD:

International Society for Clinical Densitometry

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Acknowledgements

We thank Miss Yuwei Sun for her textual revision of final manuscript.

Funding

This work was supported by grants from Fujian Province Health and Family Planning Commission (Grant No: 2015 CXB 18) and Quanzhou Science and Technology Bureau (Grant No:2014Z44). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Radiology, The Second Affiliated Hospital of Fujian Medical University, Zhongshan North road 34, Quanzhou, 362000, Fujian, China

    Siqing Cai, Xiaobo He, Lisheng Yan & Xueqing Huang

  2. Department of Orthopedics, The Second Affiliated Hospital of Fujian Medical University, Zhongshan North road 34, Quanzhou, 362000, Fujian, China

    Haiming Yu, Yizhong Li & Peiwen Wang

Authors
  1. Siqing Cai
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  2. Haiming Yu
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  3. Yizhong Li
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  4. Xiaobo He
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  5. Lisheng Yan
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  6. Xueqing Huang
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  7. Peiwen Wang
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Correspondence to Yizhong Li.

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The authors declare that they have no conflicts of interest.

Ethical approval

The participants were informed at the time of BMD measurement that their data would be included in a research study, and provided written consent. Approval for this research was given by the ethics committee of the Second Affiliated Hospital of Fujian Medical University (ERAN No:2017–111).

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Cai, S., Yu, H., Li, Y. et al. Bone mineral density measurement combined with vertebral fracture assessment increases diagnosis of osteoporosis in postmenopausal women. Skeletal Radiol 49, 273–280 (2020). https://doi.org/10.1007/s00256-019-03280-3

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  • DOI: https://doi.org/10.1007/s00256-019-03280-3

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