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BMC Geriatrics
Published in: BMC Geriatrics 1/2024

Open Access 01-12-2024 | Osteoporosis | Research

Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening

Authors: Nandong Hu, Miaomiao Wang, Meng Yang, Xin Chen, Jiangchuan Wang, Chao Xie, Bin Zhang, Zhongqiu Wang, Xiao Chen

Published in: BMC Geriatrics | Issue 1/2024

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Abstract

Background

Quantitative computed tomography (QCT)-based lumbar bone mineral density (LBMD) has been used to diagnose osteoporosis. This study explored the value of lower thoracic BMD (TBMD) in diagnosing osteoporosis in older adults during CT lung cancer screening.

Methods

This study included 751 subjects who underwent QCT scans with both LBMD and TBMD. 141 of them was selected for a validation. Osteoporosis was diagnosed based on LBMD using the ACR criteria (gold standard). TBMD thresholds were obtained using receiver operating characteristic curve. TBMD was also translated into LBMD (TTBMD) and osteoporosis was defined based on TTBMD using ACR criteria. The performance of TBMD and TTBMD in identifying osteoporosis was determined by Kappa test. The associations between TBMD- and TTBMD-based osteoporosis and fracture were tested in 227 subjects with followed up status of spine fracture.

Results

The performance of TBMD in identifying osteoporosis was low (kappa = 0.66) if using the ACR criteria. Two thresholds of TBMD for identifying osteopenia (128 mg/cm3) and osteoporosis (91 mg/cm3) were obtained with areas under the curve of 0.97 and 0.99, respectively. The performance of the identification of osteoporosis/osteopenia using the two thresholds or TTBMD both had good agreement with the gold standard (kappa = 0.78, 0.86). Similar results were observed in validation population. Osteoporosis identified using the thresholds (adjusted hazard ratio (HR) = 18.72, 95% confidence interval (CI): 5.13–68.36) or TTBMD (adjusted HR = 10.28, 95% CI: 4.22–25.08) were also associated with fractures.

Conclusion

Calculating the threshold of TBMD or normalizing TBMD to LBMD are both useful in identifying osteoporosis in older adults during CT lung cancer screening.
Appendix
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Metadata
Title
Bone mineral density in lower thoracic vertebra for osteoporosis diagnosis in older adults during CT lung cancer screening
Authors
Nandong Hu
Miaomiao Wang
Meng Yang
Xin Chen
Jiangchuan Wang
Chao Xie
Bin Zhang
Zhongqiu Wang
Xiao Chen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-024-04737-4

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