Evidence map›Paper›PMID 34773128›Full record

ArticleArchives of osteoporosis2021

How does proximal femur BMD of healthy Irish adults compare to NHANES III? Results of the DXA-HIP Project.

Erjiang E, Tingyan Wang, Lan Yang, Mary Dempsey, Attracta Brennan, Ming Yu, Wing P Chan, Bryan Whelan, Carmel Silke, Miriam O'Sullivan and 4 more

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In one paragraph

Article in Archives of osteoporosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Updated practice guideline for dual-energy X-ray absorptiometry (DXA).European journal of nuclear medicine and molecular imaging · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 4 countries.

Erjiang EDepartment of Industrial Engineering, Tsinghua University, Beijing, China.
Tingyan WangDepartment of Industrial Engineering, Tsinghua University, Beijing, China.
Lan YangDepartment of Industrial Engineering, Tsinghua University, Beijing, China.
Mary DempseySchool of Engineering, National University of Ireland, Galway, Ireland.
Attracta BrennanSchool of Computer Science, National University of Ireland, Galway, Ireland.
Ming YuDepartment of Industrial Engineering, Tsinghua University, Beijing, China.
Wing P ChanDepartment of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Bryan WhelanSchool of Medicine, National University of Ireland, Galway, Ireland.
Carmel SilkeSchool of Medicine, National University of Ireland, Galway, Ireland.
Miriam O'SullivanSchool of Medicine, National University of Ireland, Galway, Ireland.
Bridie RooneyDepartment of Geriatric Medicine, Sligo University Hospital, Sligo, Ireland.
Aoife McPartlandDepartment of Rheumatology, Our Lady's Hospital, Manorhamilton, Co. Leitrim, Ireland.
Gráinne O'MalleySchool of Medicine, National University of Ireland, Galway, Ireland.
John J CareySchool of Medicine, National University of Ireland, Galway, Ireland. john.j.carey@nuigalway.ie.
Ollscoil na Gaillimhe – University of Galway · IETsinghua University · CNOur Lady's Hospital · IESligo University Hospital · IETaipei Medical University · TWUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study examines the distribution of proximal femur bone mineral density in a cohort of healthy Irish adults. These values are similar to those of the NHANES III Caucasian cohorts, supporting international recommendations to use this reference group for calculating DXA T-scores and Z-scores in Irish adults.

introductionBone mineral density (BMD) is widely used in the assessment and monitoring of osteoporosis. International guidelines recommend referencing proximal femur BMD measurements to NHANES III values to calculate T-scores and Z-scores, but their validity for the Irish population has not been established. In this study, we compare BMD values of healthy Irish Caucasian adults to those of Caucasian men and women in the NHANES III cohort study.

methodsMen and women without bone disease and/or major risk factors for fracture, and/or not taking osteoporosis medication who had a screening DXA scan (GE Lunar, Madison, USA) at one of 3 centres in the West of Ireland were selected for this study. We calculated the mean and standard deviation (SD) used by GE for calculating white female NHANES III T-scores at the femoral neck and total hip sites, and used these values to calculate white female T-scores for men and women across each decade in our study sample. We calculated mean white female T-scores for each decade for both Caucasian men and women in the NHANES III cohort using the published data. Finally, we plotted these results against those of our study population.

resultsIn total, 6729 (18.5%) of 36,321 adults were included in our analyses, including 5923 (88%) women. The majority of the study population were aged between 40 and 89 years. Our results show that the proximal femur BMD of healthy Irish men and women is broadly similar to that of the NHANES III reference population, especially middle-aged adults. Results differ for very young and very old adults, likely reflecting the small sample size and a referral bias. Further studies of these populations and other manufacturers could help clarify these uncertainties.

conclusionsOur results support using the NHANES III reference population to calculate proximal femur adult T-scores and Z-scores to establish the presence or prevalence of osteoporosis in Ireland.

Indexed as

Bone DensityFemur NeckAbsorptiometry, PhotonAdultAgedAged, 80 and overCohort StudiesFemaleFemurHumansMaleMiddle AgedNutrition SurveysBMDDXAHealthy adultsNHANESRepublic of Ireland

Identifiers

PMID34773128
OpenAlexW3212465491

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.