J Korean Med Sci.  2014 Nov;29(11):1514-1522. 10.3346/jkms.2014.29.11.1514.

New Reference Data on Bone Mineral Density and the Prevalence of Osteoporosis in Korean Adults Aged 50 Years or Older: The Korea National Health and Nutrition Examination Survey 2008-2010

• Lee KS
• Bae SH
• Lee SH
• Lee J
• Lee DR

• KMID: 2069933
• DOI: http://doi.org/10.3346/jkms.2014.29.11.1514

Abstract

This cross-sectional study was performed to investigate the reference values for bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and the prevalence of osteoporosis in the Korean population by applying domestic reference data. In total, 25,043 Korean adults > or =20 yr of age (11,792 men and 13,251 women) participated in the study. The BMDs of the total hip, femoral neck, and lumbar spine were measured by DXA (Discovery-W, Hologic Inc.), and subjects with a BMD - 2.5 standard deviations or lower than the mean BMD for young adults (20-29 yr old) were considered to have osteoporosis. When applying the new reference values determined in this study from Korean subjects, the overall prevalence of osteoporosis increased in men aged > or =50 yr compared with that provided by the DXA manufacturer from Japanese subjects (12.2% vs. 7.8%, P<0.001) and decreased in postmenopausal women aged > or =50 yr (32.9% vs. 38.7%, P<0.001). According to the findings of this study, use of the reference values provided by the DXA manufacturer has resulted in the underdiagnosis of osteoporosis in Korean men and the overdiagnosis of osteoporosis in Korean women. Our data will serve as valuable reference standards for the diagnosis and management for osteoporosis in the Korean population.

Keyword

Bone Density; Reference Values; Osteoporosis; Absorptiometry, Photon; Korean

MeSH Terms

Absorptiometry, Photon
Adult
Aged
Asian Continental Ancestry Group
Bone Density
Cross-Sectional Studies
Female
Femur Neck/radiography
Hip/radiography
Humans
Lumbar Vertebrae/radiography
Male
Middle Aged
*Nutrition Surveys
Osteoporosis/*diagnosis/epidemiology
Prevalence
Reference Values
Republic of Korea

Figure

• 

  Fig. 1 Flow diagram for the identification of study population. KNHANES, Korea National Health and Nutrition Examination Survey; BMD, bone mineral density.

• 

  Fig. 2 Comparison of the prevalence of osteoporosis at various measurement sites based on the findings of this study (Korean) and established data supplied by the manufacturer of the DXA device (Hologic) in men (A) and postmenopausal women (B) ≥ 50 yr of age. Korean indicates the prevalence of osteoporosis as determined using the reference values from this study, and Hologic indicates the prevalence of osteoporosis as determined using the reference values provided by the manufacturer of the DXA device (based on a study of native Japanese subjects). DXA, dual-energy X-ray absorptiometry.

• 

  Fig. 3 Comparison of the prevalence of osteoporosis in men (A) and postmenopausal women (B) ≥ 50 yr of age in various age groups according to the different reference values. Osteoporosis was defined based on the WHO classification (T-score ≤ -2.5 standard deviation). Korean indicates the prevalence of osteoporosis as determined using the reference values from this study, and Hologic indicates the prevalence of osteoporosis as determined using the reference values provided by the manufacturer of the DXA device (based on a study of native Japanese subjects). DXA, dual-energy X-ray absorptiometry; WHO, World Health Organization.

• 

  Fig. 4 Comparison of the prevalence of osteoporosis in men (A and B) and postmenopausal women (C and D) ≥ 50 yr of age in various age groups and at various measurement sites according to the different reference values. Korean indicates the prevalence of osteoporosis as determined using the reference values from this study, and Hologic indicates the prevalence of osteoporosis as determined using the reference values provided by the manufacturer of the DXA device (based on a study of native Japanese subjects). DXA, dual-energy X-ray absorptiometry.

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