Osteoporos Sarcopenia.  2020 Dec;6(4):168-172. 10.1016/j.afos.2020.11.005.

Different reference ranges affect the prevalence of osteoporosis and osteopenia in an urban adult Malaysian population

• Yeap SS
• Thambiah SC
• Samsudin IN
• Appannah G
• Zainuddin N
• Mohamad-Ismuddin S
• Shahifar N
• Md-Said S
• Zahari-Sham SY
• Suppiah S
• Hew FL

• KMID: 2509970
• DOI: http://doi.org/10.1016/j.afos.2020.11.005

Abstract

Objectives
To determine the prevalence of osteopenia (OPe) and osteoporosis (OP) in an urban adult population in Malaysia, and to compare the change in the prevalence when using a Caucasian compared to an Asian reference range.
Methods
A cross-sectional random sample of the population aged between 45 and 90 years from the state of Selangor, Malaysia, was invited to attend a bone health check-up. Participants with diseases known to affect bone metabolism or who were on treatment for OP were excluded. Bone mineral density was measured using dual energy X-ray absorptiometry. Based on the World Health Organization definitions, the prevalence of OPe and OP was calculated using the Asian and Caucasian T-scores.
Results
A total of 342 subjects (222 females, 120 males), with a mean age of 59.68 (standard deviation: 8.89) years, who fulfilled the study criteria were assessed. Based on the Asian reference range, there were 140 (40.9%) subjects with OPe and 48 (14.0%) with OP. On applying the Caucasian reference range, there were 152 (44.4%) subjects with OPe and 79 (23.1%) with OP, with significant increases in males, females, and Chinese ethnic groups. Overall, 75 (21.9%) of subjects had a change in their diagnostic status. T-scores were consistently lower when the Caucasian reference range was used.
Conclusions
In a healthy urban Malaysian population, the prevalence of OP is 14.0% and OPe is 40.9%. Application of a Caucasian reference range significantly increased the number of subjects with OP and may potentially lead to over-treatment.

Keyword

Osteoporosis; Osteopenia; Reference ranges; Malaysia