Table 1. Cutoff BMD values and T-scores for osteopenia and osteoporosis based on literature data: women’s spine.
Studies | BMDyoung | SDyoung | Ageold | BMDold | SDold | T-score ≤−1.0 | T-score ≤−2.5 | Prevalence =25%¶ | Prevalence =7.5%§ | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
BMDlow | Prevalence (%) | BMDos | Prevalence (%) | BMDlow | T-score | BMDos | T-score | |||||||||
US White [2012] (52)# | 1.064 | 0.106 | ≥50 | 0.951 | 0.152 | 0.958 | 51.79 | 0.799 | 15.76 | |||||||
≥60 | 0.930 | 0.152 | 0.958 | 57.24 | 0.799 | 19.47 | ||||||||||
US Black [2012] (52) | 1.118 | 0.131 | ≥50 | 1.023 | 0.155 | 0.987 | 40.85 | 0.791 | 6.66 | |||||||
≥60 | 1.013 | 0.167 | 0.987 | 43.84 | 0.791 | 9.11 | ||||||||||
Italian [2003] (53) | 1.034 | 0.104 | 50–79 | 0.917 | 0.147 | 0.930 | 53.09 | 0.774 | 16.24 | |||||||
≥60–79 | 0.886 | 0.145 | 0.930 | 62.07 | 0.774 | 22.03 | ||||||||||
Finnish [1992] (54) | 1.196 | 0.128 | 50–70 | 1.020 | 0.140 | 1.068 | 63.57 | 0.877 | 15.48 | |||||||
60–70 | 0.949 | 0.130 | 1.068 | 82.10 | 0.877 | 29.02 | ||||||||||
Austrian [2003] (55) | 1.076 | 0.130 | 46–76 | 0.978 | 0.187 | 0.946 | 43.12 | 0.751 | 11.23 | |||||||
56–76 | 0.924 | 0.170 | 0.946 | 55.06 | 0.751 | 15.42 | ||||||||||
Canadian [2000] (56) | 1.042 | 0.121 | ≥50 | 0.921 | 0.740 | 12.10 | ||||||||||
Spanish [1997] (57) | 1.031 | 0.104 | 50–79 | 0.865 | 0.141 | 0.927 | 66.88 | 0.771 | 25.12 | |||||||
British [1996] (58) | 1.240 | 0.110 | 50–89 | 1.071 | 0.208 | 1.130 | 61.20 | 0.965 | 30.51 | |||||||
Swedish [2000] (59) | 1.057 | 0.105 | ≥70 | 0.875 | 0.162 | 0.952 | 68.27 | 0.795 | 30.96 | |||||||
Chinese meta [2013] (60) | 1.058 | 0.140 | ≥50 | 0.870 | 0.182 | 0.918 | 60.34 | 0.708 | 18.66 | 0.747 | −2.219 | 0.608 | −3.214 | |||
US Chinese [2006] (61) | 0.994 | 0.110 | 50–89 | 0.837 | 0.137 | 0.884 | 63.48 | 0.719 | 19.48 | 0.774 | −2.269 | 0.640 | −3.221 | |||
Hong Kong [2005] (51)^ | 0.990 | 0.100 | ≥60 | 0.795 | 0.140 | 0.890 | 75.28 | 0.740 | 34.78 | 0.721 | −2.686 | 0.616 | −3.743 | |||
Singapore [2020] (62) | 1.071 | 0.121 | ≥51 | 0.931 | 0.151 | 0.950 | 54.94 | 0.768 | 13.98 | 0.830 | −1.994 | 0.715 | −2.946 | |||
Japan [2001] (63)## | 1.015 | 0.105 | 50–79 | 0.810 | 0.143 | 0.910 | 75.80 | 0.752 | 34.51 | 0.713 | −2.877 | 0.603 | −3.921 | |||
ML Chinese [2007] (64) | 1.098 | 0.111 | 50–89 | 0.922 | 0.172 | 0.987 | 64.80 | 0.820 | 27.75 | 0.806 | −2.630 | 0.674 | −3.813 | |||
Korea [2008] (65)## | 1.194 | 0.120 | 50–79 | 0.922 | 0.159 | 1.074 | 83.16 | 0.894 | 43.12 | 0.814 | −3.163 | 0.693 | −4.175 | |||
Korea [2014] (66)## | 0.961 | 0.109 | ≥50 | 0.801 | 0.244* | 0.852 | 58.25 | 0.688 | 32.19 | 0.637 | −2.975 | 0.450 | −4.686 | |||
Taiwan [2011] (67) | 1.090 | 0.106 | >50 | 0.908 | 0.170 | 0.984 | 67.26 | 0.825 | 31.25 | 0.794 | −2.798 | 0.664 | −4.024 |
#, cited reference and the year of publication (see reference list). Age in years. BMD unit in g/cm2. ¶, assuming the reference Caucasian have an osteopenia prevalence of 50%, the osteopenia prevalence for Chinese ≥50 years old is assumed to be 25%. §, assuming the reference Caucasian have an osteoporosis prevalence of 15%, the osteoporosis prevalence for Chinese ≥50 years old is assumed to be 7.5% (US Blacks: 6.66%). In one study (10), we compared spine radiographs from two studies conducted in Hong Kong [MsOS (Hong Kong) n=200] and in Rome (Roman Osteoporosis Prevention Project, n=200, age-matched subjects with both mean age: 74.1 years and range: 65–87 years). The results show radiographic OVF with ≥40% vertebral height loss was recorded among 9.5% of the Chinese subjects, while among 26% of the Italian subjects. We consider osteoporosis prevalence of 7.5% for older Chinese women could be an aggressive estimation, i.e., the real prevalence could be even lower (also see Figure S2B). ^, for Hong Kong data, it is assumed that, for subjects ≥60 years, osteopenia prevalence and osteoporosis prevalence is 30% and 10% respectively. *, a large SD was obtained. ##, Kwok et al. (20) reported Hong Kong Chinese women, Beijing Chinese women, Japanese women, Korean women have very similar radiographic osteoporotic vertebral fracture prevalence. BMD, bone mineral density; ML, mainland; Chinese meta, meta-analysis result; BMDyoung, adopted value as the reference BMD; SDyoung, standard deviation of the reference young subject data; BMDold, measured BMD of the subjects ≥50 years old; SDold, standard deviation of the subjects ≥50 years old; BMDlow, the cutpoint to define osteopenia; BMDos, the cutpoint to define osteoporosis.