title: Bone mineral density (BMD) assessment of central skeletal sites from peripheral BMD and ultrasonographic measurements: an improved solution employing age and weight in type 3 regression.
abstract: The objective of this study was to develop a method whereby bone mineral density measurements of the heel and finger, as well as ultrasonographic measurements of calcaneal sound transmission, could identify individuals with a diagnosis of osteoporosis or osteopenia by the World Health Organization criteria for these diagnoses in the central skeleton (i.e., the lumbar spine (LS) and hip [femoral neck] [FN]). Two hundred and forty-four women in a university hospital laboratory setting had dual-energy X-ray absorptiometry measurements of bone mineral density (BMD) in the calcaneus, finger, hip, and spine, and quantitative ultrasound of the calcaneus. Regression equations were developed to predict central bone mineral T-scores from T-scores of peripheral measurements, adjusted by age and weight. Equations were validated by predicting the cut point for osteopenia at the lumbar spine and hip (T-score=-1.0). Ninety-five percent confidence intervals of the mean predicted LS or FN T-score from each peripheral site included -1.0. We conclude that our derived regression equations (taking into account interaction of peripheral BMD with patient age and weight) are useful for predicting T-scores in the central skeleton. This approach reduces the potential for misdiagnosis, which can result if one uses unadjusted peripheral T-scores, which are only moderately correlated with the central measurements of BMD.
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA. silbereb@healthall.com
authors.forename: Edward B
authors.initials: EB
authors.lastname: Silberstein
authors.forename: Linda L
authors.initials: LL
authors.lastname: Levin
authors.forename: Mariano
authors.initials: M
authors.lastname: Fernandez-Ulloa
authors.forename: Margery L
authors.initials: ML
authors.lastname: Gass
authors.forename: Judy H
authors.initials: JH
authors.lastname: Hughes
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D012044:Regression Analysis; D014463:Ultrasonography