Korean J Fam Pract.  2022 Apr;12(2):116-122. 10.21215/kjfp.2022.12.2.116.

Body Measurement Factors Associated with Discordance in Diagnosis of Osteoporosis Using Spinal and Hip Bone Densitometry

• Jo MS
• Choi HJ
• Lee MY
• Oh HJ

• KMID: 2528446
• DOI: http://doi.org/10.21215/kjfp.2022.12.2.116

Abstract

Background
Osteoporosis is diagnosed based on the lowest T-score at the L1–L4 lumbar spine and total hip bone mineral density (BMD). Occasionally, there is discordance in diagnosis of osteoporosis which is the presence of different categories of T-scores in two skeletal sites of an individual. We aimed to find the body measurement factors associated with discordance in diagnosing osteoporosis using spinal and total hip bone densitometry.
Methods
Data were gathered from 362 participants who had visited a Health Promotion Center. Variables were measured via body metering and dual energy x-ray absorptiometry (DXA) performed on L1–L4 lumbar spine and total hip BMD. Partial correlation analysis was performed to identify the variables related to spinal and hip BMD. Logistic regression analysis was performed to find the body measurement factors associated with discordance in diagnosing osteoporosis.
Results
The participants’ mean age was 56.8±10.7 years. Concordance of T-scores, minor discordance, and major discordance were present in 56.9%, 39.5%, and 3.6% of participants, respectively. After adjusting for age and sex, the odds ratio for the discordance in diagnosing osteoporosis was significantly higher in the 3rd and 4th quartiles of the waist-hip ratio (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.07–3.95; OR 2.13, 95% CI 1.09–4.14).
Conclusion
Even if the T-score of spinal BMD is within the normal or osteopenic range, it is necessary to measure and confirm hip BMD when the waisthip ratio is high.