title: Reasons for referral to bone densitometry in men and women aged 20-49 years: population-based data.
abstract: BACKGROUND
  Osteoporosis poses a significant public health problem for ageing Australians. However, approximately 25 % of Australian adults aged 20-49 years have osteopenia, a precursor condition to osteoporosis. Despite this, little is known about bone density testing in this age group.
  
  
  METHODS
  Reasons for referral to dual energy X-ray absorptiometry (DXA) were examined in 2,264 patients aged 20-49 years, referred in 2001-2010 to the Geelong Bone Densitometry Service, Geelong Hospital, Victoria. Referral reasons were determined from clinical indication codes derived from patient records. Age, sex and bone mineral density (BMD) T scores were ascertained for each patient.
  
  
  RESULTS
  The most common reason for referral for women reflected glucocorticoid use, and for men reflected fracture. Compared to women, men were more likely to have been referred because of minimal trauma fracture or low BMD (41.7 versus 27.1 %, p < 0.001). No further differences were identified between the sexes, with similar numbers of referral observed for secondary osteoporosis, and monitoring of drug therapy. At the spine, and for all indications, men had a significantly greater BMD deficit compared to women (all p ≤ 0.002). After age adjustment, men who were tested due to fracture or glucocorticoid reasons had significantly greater BMD at the total hip (p ≤ 0.03). No further associations were seen after age adjustment between referral reason and BMD.
  
  
  CONCLUSIONS
  Our study presents the first data examining reasons for referral to DXA among Australians aged 20-49 years. Understanding health service utilisation regarding bone health in young adults is fundamental to understanding future risk, informing effective public health messages and raising awareness of osteoporosis.
authors.affiliation: School of Medicine, Deakin University, PO Box 281, Geelong, VIC 3220, Australia.
authors.forename: Alice M J
authors.initials: AM
authors.lastname: Torpy
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Brennan
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kotowicz
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016903:Drug Monitoring / Q000706:statistics & numerical data; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
chemical_list: D005938:Glucocorticoids