ReviewSkeletal radiology2024
East Asians' T-scores for the diagnosis of osteoporosis should be calculated using ethnicity- and gender-specific BMD reference ranges: justifications.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The observation that older men suffer from hip fracture at DXA T-scores higher than older women and a proposal of a new low BMD category, osteofrailia, for predicting fracture risk in older men.Skeletal radiology · 2025Pooled it
- Artificial intelligence enabled prediction of hip fragility fracture risk using hip radiograph: an attractive approach yet more work needs to be done.Skeletal radiology · 2026Article
- Relevance of vertebral fractural deformity for hip fracture prediction: a community-based study of older Chinese women and men.Skeletal radiology · 2026Article
- The diagnostic cutoff value of vertebral bone quality score for osteoporosis is significantly influenced by the magnetic field in patients undergoing lumbar surgery.Quantitative imaging in medicine and surgery · 2025Article
- Prediction of postoperative proximal junctional kyphosis/failure in adult degenerative scoliosis via magnetic resonance imaging-based vertebral bone quality, computed tomography-based Hounsfield units, and sagittal vertical axis.Quantitative imaging in medicine and surgery · 2025Article
- Femoral bone mineral density reference values by sex and ethnicity: Findings from the Qatar Biobank study.Osteoporosis and sarcopenia · 2025Article
- Majority of hip fragility fractures among older people can be predicted by a DXA examination: an updated analysis of literature results and empirical Chinese data with a focus on the validation of the newly proposed osteofrailia criterion for men.Quantitative imaging in medicine and surgery · 2025Article
- Quantitative CT lumbar spine BMD cutpoint value for classifying osteoporosis among older East Asian women should be lower than the value for Caucasians.Skeletal radiology · 2024Article
- More evidence to support a lower quantitative computed tomography (QCT) lumbar spine bone mineral density (BMD) cutpoint value for classifying osteoporosis among older East Asian women than for Caucasians.Quantitative imaging in medicine and surgery · 2024Article
- Plain radiographic indices are reliable indicators for quantitative bone mineral density in male and female patients before total hip arthroplasty.Scientific reports · 2023Article
- Conversion of measured bone mineral density T-scores of Chinese women to equivalent Caucasian women's T-score values.Quantitative imaging in medicine and surgery · 2023Article
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9 authors.
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Abstract
The 2013 ISCD consensus recommended a Caucasian female reference database for T-score calculation in men, which says "A uniform Caucasian (non-race adjusted) female reference database should be used to calculate T-scores for men of all ethnic groups." However, this statement was recommended for the US population, and no position was taken with respect to BMD reference data or ethnicity matching outside of the USA. In East Asia, currently, a Japanese BMD reference database is universally adopted in Japan for clinical DXA diagnosis, while both local BMD and Caucasian BMD reference databases are in use in Mainland China, South Korea, Taiwan, and Singapore. In this article, we argue that an ethnicity- and gender-specific BMD database should be used for T-score calculations for East Asians, and we list the justifications why we advocate so. Use of a Caucasian BMD reference database leads to systematically lower T-scores for East Asians and an overestimation of the prevalence of osteoporosis. Using a female BMD reference database to calculate T-scores for male patients leads to higher T-score values and an underestimation of the prevalence of osteoporosis. Epidemiological evidence does not support using a female BMD reference database to calculate T-scores for men. We also note that BMD reference databases collected in Asia should be critically evaluated for their quality.
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