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Published on: January 29, 2018
Comparative evaluation of local and international reference databases for forearm densitometry: different impacts on
Szilvia Mészáros1, Péter Berko, György Genti
11st Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Summary
Using a local Hungarian reference database for forearm bone density testing significantly altered osteoporosis diagnoses in patients compared to an international database. This highlights the crucial impact of reference data selection on diagnostic outcomes.
Area of Science:
- Osteoporosis management
- Bone densitometry
- Reference database development
Background:
- Reference databases are crucial for accurate osteoporosis diagnosis using bone mineral density (BMD) measurements.
- Peripheral densitometry is a key tool, but its interpretation relies on appropriate reference data.
- Geographic variations may necessitate localized reference standards.
Purpose of the Study:
- To compare the diagnostic impact of using a local Hungarian reference database versus an international database for peripheral forearm densitometry.
- To assess how different reference databases influence osteoporosis classification in a Hungarian population.
Main Methods:
- Generated standard curves for BMD at distal and proximal forearm in 303 healthy Hungarian adults (20-94 yrs) using dual-energy X-ray absorptiometry (pDEXA).
- Determined precision error of forearm measurements (<1% in vitro, 1.2-2.5% in vivo).
- Classified 1434 patients with suspected osteoporosis using T-scores derived from both Hungarian and international reference databases.
Main Results:
- At the proximal forearm, using the Hungarian database reclassified 20% of female patients from low-density to normal categories compared to the international database.
- For males, the Hungarian database resulted in 40% more individuals classified in the low-density group than the international database.
- Distal forearm measurements showed similar classification outcomes between the two databases.
Conclusions:
- The choice of reference database significantly impacts osteoporosis diagnosis, particularly at the proximal forearm site.
- Geographic differences and the specific reference data employed can alter the prevalence of diagnosed osteoporosis.
- Localized reference databases may be necessary for precise osteoporosis diagnosis.
