Top

Osteoporosis International

Published in:

01-01-2008 | Original Article

Effects of the sample size of reference population on determining BMD reference curve and peak BMD and diagnosing osteoporosis

Authors: Y.-L. Hou, E.-Y. Liao, X.-P. Wu, Y.-Q. Peng, H. Zhang, R.-C. Dai, X.-H. Luo, X.-Z. Cao

Published in: Osteoporosis International | Issue 1/2008

Abstract

Summary

Establishing reference databases generally requires a large sample size to achieve reliable results. Our study revealed that the varying sample size from hundreds to thousands of individuals has no decisive effect on the bone mineral density (BMD) reference curve, peak BMD, and diagnosing osteoporosis. It provides a reference point for determining the sample size while establishing local BMD reference databases.

Introduction

This study attempts to determine a suitable sample size for establishing bone mineral density (BMD) reference databases in a local laboratory.

Methods

The total reference population consisted of 3,662 Chinese females aged 6–85 years. BMDs were measured with a dual-energy X-ray absorptiometry densitometer. The subjects were randomly divided into four different sample groups, that is, total number (Tn) = 3,662, 1/2n = 1,831, 1/4n = 916, and 1/8n = 458. We used the best regression model to determine BMD reference curve and peak BMD.

Results

There was no significant difference in the full curves between the four sample groups at each skeletal site, although some discrepancy at the end of the curves was observed at the spine. Peak BMDs were very similar in the four sample groups. According to the Chinese diagnostic criteria (BMD >25% below the peak BMD as osteoporosis), no difference was observed in the osteoporosis detection rate using the reference values determined by the four different sample groups.

Conclusions

Varying the sample size from hundreds to thousands has no decisive effect on establishing BMD reference curve and determining peak BMD. It should be practical for determining the reference population while establishing local BMD databases.

Liao EY, Wu XP, Luo XH et al (2003) Establishment and evaluation of bone mineral density reference databases appropriate for diagnosis and evaluation of osteoporosis in Chinese women. J Bone Miner Metab 21:184–192PubMedCrossRef

Wu XP, Liao EY, Zhang H et al (2004) Establishment of BMD reference plots and determination of peak BMD at multiple skeletal regions in mainland Chinese women and the diagnosis of osteoporosis. Osteoporos Int 15:71–79PubMedCrossRef

Looker AC, Wahner HW, Dunn WL et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef

Nakamura K, Tanaka Y, Saitou K et al (2000) Age and sex differences in the bone mineral density of the distal forearm based on health check-up data of 6343 Japanese. Osteoporos Int 11:772–777PubMedCrossRef

Iki M, Kagamimori S, Kagawa Y et al (2001) Bone mineral density of the spine, hip and distal forearm in representative samples of the Japanese female population: Japanese Population-Based Osteoporosis (JPOS) Study. Osteoporos Int 12:529–537PubMedCrossRef

Lynn HS, Lau EM, Au B et al (2005) Bone mineral density reference norms for Hong Kong Chinese. Osteoporos Int 16:1663–1668PubMedCrossRef

Pedrazzoni M, Girasole G, Bertoldo F et al (2003) Definition of a population-specific DXA reference standard in Italian women: the Densitometric Italian Normative Study (DINS). Osteoporos Int 14:978–982PubMedCrossRef

Forsmo S, Langhammer A, Forsen L et al (2005) Forearm bone mineral density in an unselected population of 2,779 men and women—the HUNT Study, Norway. Osteoporos Int 16:562–567PubMedCrossRef

Ardawi MS, Maimany AA, Bahksh TM et al (2005) Bone mineral density of the spine and femur in healthy Saudis. Osteoporos Int 16:43–55PubMedCrossRef

10.

Mazess RB, Barden H (1999) Bone density of the spine and femur in adult white females. Calcif Tissue Int 65:91–99PubMedCrossRef

11.

Maalouf G, Salem S, Sandid M et al (2000) Bone mineral density of the Lebanese reference population. Osteoporos Int 11:756–764PubMedCrossRef

12.

Dougherty G, Al-Marzouk N (2001) Bone density measured by dual-energy X-ray absorptiometry in healthy Kuwaiti women. Calcif Tissue Int 68:225–229PubMedCrossRef

13.

Yao WJ, Wu CH, Wang ST et al (2001) Differential changes in regional bone mineral density in healthy Chinese: age-related and sex-dependent. Calcif Tissue Int 68:330–336PubMedCrossRef

14.

Manisali M, Ozaksoy D, Yilmaz E et al (2003) Bone mineral density reference values in the normal female and male population of Izmir, Turkey. Eur Radiol 13:157–162PubMed

15.

El Maghraoui A, Guerboub AA, Achemlal L et al (2006) Bone mineral density of the spine and femur in healthy Moroccan women. J Clin Densitom 9:454–460PubMedCrossRef

16.

Walker MD, Babbar R, Opotowsky AR et al (2006) A referent bone mineral density database for Chinese American women. Osteoporos Int 17:878–887PubMedCrossRef

17.

Kelly TL (1992) Study protocol QDR reference databases. Hologic, Inc., Bedford, MA

18.

Peel NF, Eastell R (1994) Diagnostic value of estimated volumetric bone mineral density of the lumbar spine in osteoporosis. J Bone Miner Res 9:317–320PubMed

19.

Bonnick SL, Johnston CC Jr, Kleerekoper M et al (2001) Importance of precision in bone density measurements. J Clin Densitom 4:105–110PubMedCrossRef

20.

Liu Z, Piao J, Pang L et al (2002) The diagnostic criteria for primary osteoporosis and the incidence of osteoporosis in China. J Bone Miner Metab 20:181–189PubMedCrossRef

21.

Kanis JA, Melton LJ 3rd, Christiansen C et al (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedCrossRef

22.

Deleze M, Cons-Molina F, Villa AR et al (2000) Geographic differences in bone mineral density of Mexican women. Osteoporos Int 11:562–569PubMedCrossRef

23.

Tenenhouse A, Joseph L, Kreiger N et al (2000) Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporos Int 11:897–904PubMedCrossRef

24.

Kaneko M, Miyake T, Yokoyama E et al (2000) Standard radial bone mineral density and physical factors in ordinary Japanese women. J Bone Miner Metab 18:31–35PubMedCrossRef

25.

Molyvda-Athanasopoulou E, Sioundas A, Hatziioannou K (2000) Dual energy X-ray absorptiometry reference data for Greek population. The impact on diagnosis of using various normal ranges for comparison. Eur J Radiol 36:36–40PubMedCrossRef

26.

Orimo H, Hayashi Y, Fukunaga M et al (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337PubMedCrossRef

Title: Effects of the sample size of reference population on determining BMD reference curve and peak BMD and diagnosing osteoporosis
Authors: Y.-L. Hou
E.-Y. Liao
X.-P. Wu
Y.-Q. Peng
H. Zhang
R.-C. Dai
X.-H. Luo
X.-Z. Cao
Publication date: 01-01-2008
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 1/2008
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-007-0436-7

At a glance: The STEP trials

Springer Medicine

Effects of the sample size of reference population on determining BMD reference curve and peak BMD and diagnosing osteoporosis

Abstract

Summary

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2008

Uptake and adherence with soft- and hard-shelled hip protectors in Norwegian nursing homes: a cluster randomised trial

Prevalence of vitamin D depletion among subjects seeking advice on osteoporosis: a five-year cross-sectional study with public health implications

Association between height loss and bone loss, cumulative incidence of vertebral fractures and future quality of life: the Miyama study

Distal renal tubular acidosis and ovalocytosis: a case report

Reply to McKiernan: Vertebral height restoration: deflating the rhetoric

The relationship between body composition and bone mineral content: threshold effects in a racially and ethnically diverse group of men