Skip to main content
NCBI home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1995 Oct;54(10):807–810. doi: 10.1136/ard.54.10.807

Cut off values of bone mineral density defining postmenopausal women with bone fractures.

G G Riario-Sforza 1, C Incorvaia 1, A Scazzoso 1, T Travisi 1, F Nitti 1, M Fumagalli 1
PMCID: PMC1010014  PMID: 7492218

Abstract

OBJECTIVES--To define cut off values of bone mineral density (BMD), measured at different forearm sites by single photon absorptiometry, that discriminated postmenopausal women who have had fractures from those who have not, in order to provide an index of fracture risk for screening purposes. METHODS--BMD values were measured at distal third radius (DTR) and ultradistal radius (UDR) sites in two groups of postmenopausal women. Group 1 (n = 398) had not suffered fractures, and group 2 (n = 354) had appendicular fractures. Results were evaluated using receiver operating characteristic (ROC) curves. RESULTS--BMD values were significantly greater (p < 0.001) at both sites in group 1. Weight was lower in group 2 than in group 1 (p < 0.001). The BMD cut off value was 0.596 g/cm2 at DTR (sensitivity 63%, specificity 72%), and 0.310 g/cm2 at UDR (sensitivity 80%, specificity 80%). Values of area under ROC curves estimated for UDR were greater than for those DTR (p < 0.001). CONCLUSION--For screening purposes the BMD cut off value of 0.310 g/cm2 at the UDR may be useful in identifying women at high risk of fracture in an unselected postmenopausal population. BMD measured at UDR appeared to have a better predictive value than that at DTR.

Full text

PDF
807

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abrams B., Parker J. D. Maternal weight gain in women with good pregnancy outcome. Obstet Gynecol. 1990 Jul;76(1):1–7. [PubMed] [Google Scholar]
  2. Cummings S. R., Black D. M., Nevitt M. C., Browner W. S., Cauley J. A., Genant H. K., Mascioli S. R., Scott J. C., Seeley D. G., Steiger P. Appendicular bone density and age predict hip fracture in women. The Study of Osteoporotic Fractures Research Group. JAMA. 1990 Feb 2;263(5):665–668. [PubMed] [Google Scholar]
  3. Gärdsell P., Johnell O., Nilsson B. E. Predicting fractures in women by using forearm bone densitometry. Calcif Tissue Int. 1989 Apr;44(4):235–242. doi: 10.1007/BF02553757. [DOI] [PubMed] [Google Scholar]
  4. Halioua L., Anderson J. J. Age and anthropometric determinants of radial bone mass in premenopausal Caucasian women: a cross-sectional study. Osteoporos Int. 1990 Oct;1(1):50–55. doi: 10.1007/BF01880416. [DOI] [PubMed] [Google Scholar]
  5. Hanley J. A., McNeil B. J. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982 Apr;143(1):29–36. doi: 10.1148/radiology.143.1.7063747. [DOI] [PubMed] [Google Scholar]
  6. Hansen M. A., Overgaard K., Riis B. J., Christiansen C. Potential risk factors for development of postmenopausal osteoporosis--examined over a 12-year period. Osteoporos Int. 1991 Feb;1(2):95–102. doi: 10.1007/BF01880450. [DOI] [PubMed] [Google Scholar]
  7. Heaney R. P., Gallagher J. C., Johnston C. C., Neer R., Parfitt A. M., Whedon G. D. Calcium nutrition and bone health in the elderly. Am J Clin Nutr. 1982 Nov;36(5 Suppl):986–1013. doi: 10.1093/ajcn/36.5.986. [DOI] [PubMed] [Google Scholar]
  8. Hui S. L., Wiske P. S., Norton J. A., Johnston C. C., Jr A prospective study of change in bone mass with age in postmenopausal women. J Chronic Dis. 1982;35(9):715–725. doi: 10.1016/0021-9681(82)90095-9. [DOI] [PubMed] [Google Scholar]
  9. Johnston C. C., Jr, Slemenda C. W., Melton L. J., 3rd Clinical use of bone densitometry. N Engl J Med. 1991 Apr 18;324(16):1105–1109. doi: 10.1056/NEJM199104183241606. [DOI] [PubMed] [Google Scholar]
  10. Kanis J. A., Adami S. Bone loss in the elderly. Osteoporos Int. 1994;4 (Suppl 1):59–65. doi: 10.1007/BF01623438. [DOI] [PubMed] [Google Scholar]
  11. Mazess R. B., Peppler W. W., Chesney R. W., Lange T. A., Lindgren U., Smith E., Jr Does bone measurement on the radius indicate skeletal status? Concise communication. J Nucl Med. 1984 Mar;25(3):281–288. [PubMed] [Google Scholar]
  12. McNeil B. J., Hanley J. A. Statistical approaches to the analysis of receiver operating characteristic (ROC) curves. Med Decis Making. 1984;4(2):137–150. doi: 10.1177/0272989X8400400203. [DOI] [PubMed] [Google Scholar]
  13. Need A. G., Nordin B. E. Which bone to measure? Osteoporos Int. 1990 Oct;1(1):3–6. doi: 10.1007/BF01880409. [DOI] [PubMed] [Google Scholar]
  14. Nordin B. E. The definition and diagnosis of osteoporosis. Calcif Tissue Int. 1987 Feb;40(2):57–58. doi: 10.1007/BF02555705. [DOI] [PubMed] [Google Scholar]
  15. Pacifici R., Rupich R., Vered I., Fischer K. C., Griffin M., Susman N., Avioli L. V. Dual energy radiography (DER): a preliminary comparative study. Calcif Tissue Int. 1988 Sep;43(3):189–191. doi: 10.1007/BF02571319. [DOI] [PubMed] [Google Scholar]
  16. Pearson J., Ruegsegger P., Dequeker J., Henley M., Bright J., Reeve J., Kalender W., Felsenberg D., Laval-Jeantet A. M., Adams J. E. European semi-anthropomorphic phantom for the cross-calibration of peripheral bone densitometers: assessment of precision accuracy and stability. Bone Miner. 1994 Nov;27(2):109–120. doi: 10.1016/s0169-6009(08)80213-9. [DOI] [PubMed] [Google Scholar]
  17. Raymakers J. A., Hoekstra O., van Putten J., Kerkhoff H., Duursma S. A. Fracture prevalence and bone mineral mass in osteoporosis measured with computed tomography and dual energy photon absorptiometry. Skeletal Radiol. 1986;15(3):191–197. doi: 10.1007/BF00354059. [DOI] [PubMed] [Google Scholar]
  18. Riggs B. L., Wahner H. W., Seeman E., Offord K. P., Dunn W. L., Mazess R. B., Johnson K. A., Melton L. J., 3rd Changes in bone mineral density of the proximal femur and spine with aging. Differences between the postmenopausal and senile osteoporosis syndromes. J Clin Invest. 1982 Oct;70(4):716–723. doi: 10.1172/JCI110667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Schlenker R. A., VonSeggen W. W. The distribution of cortical and trabecular bone mass along the lengths of the radius and ulna and the implications for in vivo bone mass measurements. Calcif Tissue Res. 1976 Apr 13;20(1):41–52. doi: 10.1007/BF02546396. [DOI] [PubMed] [Google Scholar]
  20. Tosteson A. N., Rosenthal D. I., Melton L. J., 3rd, Weinstein M. C. Cost effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med. 1990 Oct 15;113(8):594–603. doi: 10.7326/0003-4819-113-8-594. [DOI] [PubMed] [Google Scholar]
  21. Utian W. H. Overview on menopause. Am J Obstet Gynecol. 1987 May;156(5):1280–1283. doi: 10.1016/0002-9378(87)90164-5. [DOI] [PubMed] [Google Scholar]
  22. Wasnich R. D., Ross P. D., Heilbrun L. K., Vogel J. M. Prediction of postmenopausal fracture risk with use of bone mineral measurements. Am J Obstet Gynecol. 1985 Dec 1;153(7):745–751. doi: 10.1016/0002-9378(85)90338-2. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES