Influence of Recently Published Reference Database for Peak Bone Mineral Density on the Diagnosis of Osteoporosis and Osteopenia in Asian Indian Women Living in the USA

Document Type

Conference Proceeding

Publication Date

2-9-2022

Publication Title

J Bone Miner Res

Abstract

Classification of osteoporosis or osteopenia in postmenopausal women of various racial/ ethnic backgrounds in the US is based on Caucasian reference bone mineral density (BMD) data. South Asian women have lower BMD than White women. We recently published peak BMD reference data for healthy population living in North India, the Chandigarh Urban Bone Epidemiological Study (CUBES), which is the most comprehensive normative database for this population thus far from India. The influence of the CUBES reference data on the diagnosis of osteoporosis or osteopenia in Asian Indian women living in the USA is unknown. Accordingly, we studied the effect of CUBES database on the diagnostic categorization. Methods: Postmenopausal women of Asian Indian women evaluated or consulted in the Bone & Mineral Clinic; Henry Ford Health System were included in this study. Of the 74 women, 53 had BMD measured by the Hologic and 21 by the GE-Lunar instrument. The CUBES data was generated using Hologic instrument.Results: Mean age was 59.1 +/- 10.4y. Mean lumbar spine BMD was 0.858 +/- 0.158 g/Cm2 with a mean T-score of -2.1 +/- 1.13 SD based on the US reference data. Using the CUBES reference data resulted in a mean T-score of -1.11 +/- 1.53 SD. The corresponding values for the femoral neck were: BMD 0.724 +/- 0.107 g/Cm2; T-score -1.61 +/- 0.80 SD (US reference data) and -0.63 +/- 0.98 SD (CUBES reference data). The proportion with osteoporosis, osteopenia, and normal is shown in the Figure. We did not test for the significance of difference in T-scores by the 2 databases for obvious reasons. Also, the 23 Lunar measurements were assumed to be “Hologic” for this preliminary study.Conclusions: Use of ethnic specific reference data in Asian Indian women yields higher T-scores by approximately 1.0 SD, thereby resulting in a large proportion of these women reclassified from having osteoporosis to osteopenia. A higher proportion of Asian Indian women would be diagnosed with osteoporosis or osteopenia by the US database, and by inference treated, than based on CUBES database. Ethnic specific CUBES BMD database should be used to categorize Asian Indian women living in the US. This is analogous to current clinical practice of ethnic/country/disease (Turner's for instance) specific reference data for height, weight, BMI etc. (Figure Presented).

Volume

37

First Page

134

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