Dual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults.
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Authors
Carey, John JDelaney, 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.ieIssue Date
2009Keywords
BONE DENSITYYOUNG ADULT
MeSH
Absorptiometry, PhotonAdult
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
Metadata
Show full item recordCitation
Dual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults., 12 (1):11-6 J Clin DensitomJournal
Journal of clinical densitometry : the official journal of the International Society for Clinical DensitometryDOI
10.1016/j.jocd.2008.11.001PubMed ID
19195620Additional Links
http://www.ncbi.nlm.nih.gov/pubmed/19195620Abstract
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
ArticleLanguage
enISSN
1094-6950ae974a485f413a2113503eed53cd6c53
10.1016/j.jocd.2008.11.001
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