Discordance in DXA male reference ranges.

Area of Science:

• Bone Densitometry
• Osteoporosis Diagnosis
• Medical Imaging Physics

Background:

• Dual-energy X-ray absorptiometry (DXA) is crucial for osteoporosis assessment.
• Previous research indicated discordance in female DXA reference ranges for lumbar spine and proximal femur.
• Manufacturer-specific reference ranges for lumbar spine bone mineral density (BMD) in men lack published concordance data.

Purpose of the Study:

• To compare lumbar spine BMD, T-scores, and Z-scores between two densitometer manufacturers in men.
• To investigate potential inconsistencies in osteopenia or osteoporosis diagnosis due to differing reference populations.
• To assess the concordance of manufacturer-specific lumbar spine BMD reference ranges in a male cohort.

Main Methods:

• Compared lumbar spine BMD, T-scores, and Z-scores in 45 men.
• Utilized Lunar DPXL and Norland Excel densitometers for scanning.
• Analyzed the correlation and differences in BMD measurements and derived scores.

Main Results:

• High correlation (r = 0.99) was observed between BMD measurements from both instruments.
• Significant differences were found in assigned BMD T-scores and age-matched Z-scores.
• Discrepancies in T-scores were primarily attributed to differing standard deviations in reference range calculations.

Conclusions:

• Commonly used DXA instruments provide comparable standardized lumbar spine BMD in men.
• Significant differences in T-scores arise from manufacturer-specific reference ranges, impacting diagnostic accuracy.
• Standardization of lumbar spine reference ranges for men is a high priority for consistent osteoporosis diagnosis.