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Research article
Kexun Chen
Geriatric Education and Research Institute Ltd
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6280-0391
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
While there have been studies in Singapore on the prevalence and economic burden of osteoporotic hip fracture, there is a severe lack of reference data on bone mineral density and prevalence of osteoporosis. The purpose of this study is to establish the reference values for BMD and compare prevalence of osteoporotic conditions using other available reference values so as to better understand the status of bone health in Singaporean adults.
Methods
We carried out a population-based cross-sectional study using dual-energy x-ray absorptiometry (Hologic Discovery Wi) to measure the bone mineral density of Singaporean adults aged ≥ 21 years. A total of 542 participants were recruited from the large north-eastern residential town of Yishun. We computed T- scores (denoted by TSG) for each individual in the study. Similar diagnoses were also done based on T-scores provided by the densitometer (TDXA), NHANES database (TNHANES), and China (TCHN), and the differences in prevalence compared. We then compared the concordance between TSG and TDXA in the classification of osteoporosis. Osteoporosis was defined according to criteria by the World Health Organization (WHO).
Results
Peak lumbar spine BMD was 1.093±0.168g/cm2 in women, and 1.041±0.098g/cm2 for men. Peak whole-body BMD was 1.193±0.93g/cm2 in women at, and 1.224±0.112g/cm2 for men. Prevalence of osteoporosis based on lumbar spine was 9.3% in postmenopausal women, and 0.7% in men after 50 years of age. The percentage difference in prevalence range from 60.5 - 163.6%, when using reference values from TDXA, TNHANES, and TCHN. Comparing diagnosis using TDXA and TSG cut-off values, 28 versus 15 women were diagnosed as osteoporotic respectively. The kappa statistics was 0.81 for women and 0.85 for men.
Conclusion
Our study shows that T-scores provided by DXA manufacturer over-diagnosed osteoporosis in Singaporeans, and the prevalence of osteoporotic conditions is not accurately represented. This over-diagnosis may result in unnecessary treatment in some individuals.
Keywords
Bone mineral density, Reference range, Osteoporosis, Prevalence, Normative
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CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Submission checks complete
On 15 Sep, 2020
Editorial decision: Accept
On 11 Sep, 2020
Editor assigned
On 09 Sep, 2020
Editor invited
On 09 Sep, 2020
Version 4
Posted 02 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 09 Sep, 2020
Editor assigned
On 27 Aug, 2020
Submission checks complete
On 26 Aug, 2020
Editor invited
On 26 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 26 Aug, 2020
Reviewer #1 agreed
On 24 Aug, 2020
Review #1 received
Received 24 Aug, 2020
Reviewers invited
Invitations sent on 23 Aug, 2020
Editor assigned
On 13 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 12 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 06 Aug, 2020
Review #1 received
Received 30 Jul, 2020
Review #2 received
Received 30 Jul, 2020
Reviewer #1 agreed
On 29 Jul, 2020
Reviewer #2 agreed
On 29 Jul, 2020
Reviewers invited
Invitations sent on 28 Jul, 2020
Editor assigned
On 27 Jul, 2020
Submission checks complete
On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
No comments provided
Editorial decision: Major revision
On 18 Jul, 2020
Review #2 received
Received 14 Jul, 2020
Review #1 received
Received 14 Jul, 2020
Reviewer #1 agreed
On 29 Jun, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Reviewers invited
Invitations sent on 24 Jun, 2020
Editor assigned
On 22 Jun, 2020
Submission checks complete
On 22 Jun, 2020
Editor invited
On 22 Jun, 2020
First submitted
On 18 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Musculoskeletal Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Kexun Chen
Geriatric Education and Research Institute Ltd
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6280-0391
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Submission checks complete
On 15 Sep, 2020
Editorial decision: Accept
On 11 Sep, 2020
Editor assigned
On 09 Sep, 2020
Editor invited
On 09 Sep, 2020
Version 4
Posted 02 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 09 Sep, 2020
Editor assigned
On 27 Aug, 2020
Submission checks complete
On 26 Aug, 2020
Editor invited
On 26 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 26 Aug, 2020
Reviewer #1 agreed
On 24 Aug, 2020
Review #1 received
Received 24 Aug, 2020
Reviewers invited
Invitations sent on 23 Aug, 2020
Editor assigned
On 13 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 12 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 06 Aug, 2020
Review #1 received
Received 30 Jul, 2020
Review #2 received
Received 30 Jul, 2020
Reviewer #1 agreed
On 29 Jul, 2020
Reviewer #2 agreed
On 29 Jul, 2020
Reviewers invited
Invitations sent on 28 Jul, 2020
Editor assigned
On 27 Jul, 2020
Submission checks complete
On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
No comments provided
Editorial decision: Major revision
On 18 Jul, 2020
Review #2 received
Received 14 Jul, 2020
Review #1 received
Received 14 Jul, 2020
Reviewer #1 agreed
On 29 Jun, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Reviewers invited
Invitations sent on 24 Jun, 2020
Editor assigned
On 22 Jun, 2020
Submission checks complete
On 22 Jun, 2020
Editor invited
On 22 Jun, 2020
First submitted
On 18 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
Background
While there have been studies in Singapore on the prevalence and economic burden of osteoporotic hip fracture, there is a severe lack of reference data on bone mineral density and prevalence of osteoporosis. The purpose of this study is to establish the reference values for BMD and compare prevalence of osteoporotic conditions using other available reference values so as to better understand the status of bone health in Singaporean adults.
Methods
We carried out a population-based cross-sectional study using dual-energy x-ray absorptiometry (Hologic Discovery Wi) to measure the bone mineral density of Singaporean adults aged ≥ 21 years. A total of 542 participants were recruited from the large north-eastern residential town of Yishun. We computed T- scores (denoted by TSG) for each individual in the study. Similar diagnoses were also done based on T-scores provided by the densitometer (TDXA), NHANES database (TNHANES), and China (TCHN), and the differences in prevalence compared. We then compared the concordance between TSG and TDXA in the classification of osteoporosis. Osteoporosis was defined according to criteria by the World Health Organization (WHO).
Results
Peak lumbar spine BMD was 1.093±0.168g/cm2 in women, and 1.041±0.098g/cm2 for men. Peak whole-body BMD was 1.193±0.93g/cm2 in women at, and 1.224±0.112g/cm2 for men. Prevalence of osteoporosis based on lumbar spine was 9.3% in postmenopausal women, and 0.7% in men after 50 years of age. The percentage difference in prevalence range from 60.5 - 163.6%, when using reference values from TDXA, TNHANES, and TCHN. Comparing diagnosis using TDXA and TSG cut-off values, 28 versus 15 women were diagnosed as osteoporotic respectively. The kappa statistics was 0.81 for women and 0.85 for men.
Conclusion
Our study shows that T-scores provided by DXA manufacturer over-diagnosed osteoporosis in Singaporeans, and the prevalence of osteoporotic conditions is not accurately represented. This over-diagnosis may result in unnecessary treatment in some individuals.
Figure 1
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