Dual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults.

Hdl Handle:
http://hdl.handle.net/10147/302660
Title:
Dual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults.
Authors:
Carey, John J; Delaney, Miriam F; Love, Thomas E; Cromer, Barbara A; Miller, Paul D; Richmond, Bradford J; Manilla-McIntosh, Martha; Lewis, Steven A; Thomas, Charles L; Licata, Angelo A
Affiliation:
Department of Rheumatology, Merlin Park University Hospital, Galway, Ireland. John.carey@hse.ie
Citation:
Dual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults., 12 (1):11-6 J Clin Densitom
Publisher:
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
Journal:
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
Issue Date:
2009
URI:
http://hdl.handle.net/10147/302660
DOI:
10.1016/j.jocd.2008.11.001
PubMed ID:
19195620
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/19195620
Abstract:
Diagnostic criteria for postmenopausal osteoporosis using central dual-energy X-ray absorptiometry (DXA) T-scores have been widely accepted. The validity of these criteria for other populations, including premenopausal women and young men, has not been established. The International Society for Clinical Densitometry (ISCD) recommends using DXA Z-scores, not T-scores, for diagnosis in premenopausal women and men aged 20-49 yr, though studies supporting this position have not been published. We examined diagnostic agreement between DXA-generated T-scores and Z-scores in a cohort of men and women aged 20-49 yr, using 1994 World Health Organization and 2005 ISCD DXA criteria. Four thousand two hundred and seventy-five unique subjects were available for analysis. The agreement between DXA T-scores and Z-scores was moderate (Cohen's kappa: 0.53-0.75). The use of Z-scores resulted in significantly fewer (McNemar's p<0.001) subjects diagnosed with "osteopenia," "low bone mass for age," or "osteoporosis." Thirty-nine percent of Hologic (Hologic, Inc., Bedford, MA) subjects and 30% of Lunar (GE Lunar, GE Madison, WI) subjects diagnosed with "osteoporosis" by T-score were reclassified as either "normal" or "osteopenia" when their Z-score was used. Substitution of DXA Z-scores for T-scores results in significant diagnostic disagreement and significantly fewer persons being diagnosed with low bone mineral density.
Item Type:
Article
Language:
en
Keywords:
BONE DENSITY; YOUNG ADULT
MeSH:
Absorptiometry, Photon; Adult; Cross-Sectional Studies; Female; Femur; Femur Neck; Hip; Humans; Logistic Models; Lumbar Vertebrae; Male; Middle Aged; Osteoporosis; Osteoporosis, Postmenopausal; Reproducibility of Results; Sensitivity and Specificity; Software
ISSN:
1094-6950

Full metadata record

DC FieldValue Language
dc.contributor.authorCarey, John Jen_GB
dc.contributor.authorDelaney, Miriam Fen_GB
dc.contributor.authorLove, Thomas Een_GB
dc.contributor.authorCromer, Barbara Aen_GB
dc.contributor.authorMiller, Paul Den_GB
dc.contributor.authorRichmond, Bradford Jen_GB
dc.contributor.authorManilla-McIntosh, Marthaen_GB
dc.contributor.authorLewis, Steven Aen_GB
dc.contributor.authorThomas, Charles Len_GB
dc.contributor.authorLicata, Angelo Aen_GB
dc.date.accessioned2013-10-03T14:27:40Z-
dc.date.available2013-10-03T14:27:40Z-
dc.date.issued2009-
dc.identifier.citationDual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults., 12 (1):11-6 J Clin Densitomen_GB
dc.identifier.issn1094-6950-
dc.identifier.pmid19195620-
dc.identifier.doi10.1016/j.jocd.2008.11.001-
dc.identifier.urihttp://hdl.handle.net/10147/302660-
dc.description.abstractDiagnostic criteria for postmenopausal osteoporosis using central dual-energy X-ray absorptiometry (DXA) T-scores have been widely accepted. The validity of these criteria for other populations, including premenopausal women and young men, has not been established. The International Society for Clinical Densitometry (ISCD) recommends using DXA Z-scores, not T-scores, for diagnosis in premenopausal women and men aged 20-49 yr, though studies supporting this position have not been published. We examined diagnostic agreement between DXA-generated T-scores and Z-scores in a cohort of men and women aged 20-49 yr, using 1994 World Health Organization and 2005 ISCD DXA criteria. Four thousand two hundred and seventy-five unique subjects were available for analysis. The agreement between DXA T-scores and Z-scores was moderate (Cohen's kappa: 0.53-0.75). The use of Z-scores resulted in significantly fewer (McNemar's p<0.001) subjects diagnosed with "osteopenia," "low bone mass for age," or "osteoporosis." Thirty-nine percent of Hologic (Hologic, Inc., Bedford, MA) subjects and 30% of Lunar (GE Lunar, GE Madison, WI) subjects diagnosed with "osteoporosis" by T-score were reclassified as either "normal" or "osteopenia" when their Z-score was used. Substitution of DXA Z-scores for T-scores results in significant diagnostic disagreement and significantly fewer persons being diagnosed with low bone mineral density.en_GB
dc.language.isoenen
dc.publisherJournal of clinical densitometry : the official journal of the International Society for Clinical Densitometryen_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/19195620en_GB
dc.rightsArchived with thanks to Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometryen_GB
dc.subjectBONE DENSITYen_GB
dc.subjectYOUNG ADULTen_GB
dc.subject.meshAbsorptiometry, Photon-
dc.subject.meshAdult-
dc.subject.meshCross-Sectional Studies-
dc.subject.meshFemale-
dc.subject.meshFemur-
dc.subject.meshFemur Neck-
dc.subject.meshHip-
dc.subject.meshHumans-
dc.subject.meshLogistic Models-
dc.subject.meshLumbar Vertebrae-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshOsteoporosis-
dc.subject.meshOsteoporosis, Postmenopausal-
dc.subject.meshReproducibility of Results-
dc.subject.meshSensitivity and Specificity-
dc.subject.meshSoftware-
dc.titleDual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Rheumatology, Merlin Park University Hospital, Galway, Ireland. John.carey@hse.ieen_GB
dc.identifier.journalJournal of clinical densitometry : the official journal of the International Society for Clinical Densitometryen_GB
dc.description.fundingNo fundingen
dc.description.provinceConnachten
dc.description.peer-reviewpeer-reviewen
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