Scholarlink

Summary <p>This study used modified criteria to exclude osteoporosis and osteopenia from elevated bone mass (EBM) to avoid a diagnostic paradox and demonstrated that diffuse idiopathic skeletal hyperostosis (DISH), severe lumbar degenerative disease (LDD), elevated body mass index (BMI), and diabetes are key risk factors for super EBM (SEBM).</p> Purpose <p>The current criteria classify individuals with both EBM and osteopenia/osteoporosis. To avoid this contradiction, we used a modified criterion to exclude osteoporosis or osteopenia from EBM and to examine the clinical impact and risk factors of EBM.</p> Methods <p>In this retrospective study, bone mineral density (BMD) data from participants aged 18&#xa0;years or older collected at a tertiary hospital between 2021 and 2023 were analyzed. Inclusion criteria were complete Z-scores and T-scores for the lumbar spine, femoral neck, and total hip. Participants with a history of lumbar spine surgery or hip arthroplasty prior to BMD measurement were excluded. Normal bone mass (NBM) was defined as T-scores ≥ –1.0 at all sites and Z-scores &lt; 2.5 at any site. EBM was defined as NBM plus Z-scores ≥ 2.5 at any site. EBM was further subdivided into moderate EBM (MEBM) with Z-scores between 2.5 and 4.0, and SEBM with Z-scores ≥ 4.0. Demographic data, medical history, and comorbidities were collected and analyzed.</p> Results <p>Of the 33,479 eligible participants, 1,472 (4.4%) were identified with EBM. The EBM group was divided into 1,267 (3.8%) with MEBM and 205 (0.6%) with SEBM. SEBM group had a significantly higher proportion of men and a higher BMI than the MEBM group (p &lt; 0.001). In addition, SEBM group had a higher prevalence of conditions such as DISH, ankylosing spondylitis (AS), LDD, and diabetes (p &lt; 0.001). Different correlation trends between BMI, T-scores, and Z-scores were observed in the SEBM and MEBM groups. Chi-squared Automatic Interaction Detection (CHAID) analysis identified DISH as the strongest predictor of SEBM, while severe LDD, increased BMI, and diabetes were contributing factors for SEBM.</p> Conclusions <p>Using the modified criteria for EBM, which exclude cases of osteoporosis and osteopenia, SEBM has a higher rate of comorbidities compared to MEBM. The presence of DISH, higher severity of LDD, increased BMI, and diabetes were identified as strong risk factor of SEBM.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Modified criteria for identifying elevated bone mass

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月6日

查看全文
  • Jiangjie Chen,
  • Lingling Cao,
  • Chenghao Xu,
  • Fangying Lu,
  • Liwei Zhang,
  • Anpeng Xu,
  • Yahong Chen,
  • Tao-Hsin Tung,
  • Dun Hong

摘要

Summary

This study used modified criteria to exclude osteoporosis and osteopenia from elevated bone mass (EBM) to avoid a diagnostic paradox and demonstrated that diffuse idiopathic skeletal hyperostosis (DISH), severe lumbar degenerative disease (LDD), elevated body mass index (BMI), and diabetes are key risk factors for super EBM (SEBM).

Purpose

The current criteria classify individuals with both EBM and osteopenia/osteoporosis. To avoid this contradiction, we used a modified criterion to exclude osteoporosis or osteopenia from EBM and to examine the clinical impact and risk factors of EBM.

Methods

In this retrospective study, bone mineral density (BMD) data from participants aged 18 years or older collected at a tertiary hospital between 2021 and 2023 were analyzed. Inclusion criteria were complete Z-scores and T-scores for the lumbar spine, femoral neck, and total hip. Participants with a history of lumbar spine surgery or hip arthroplasty prior to BMD measurement were excluded. Normal bone mass (NBM) was defined as T-scores ≥ –1.0 at all sites and Z-scores < 2.5 at any site. EBM was defined as NBM plus Z-scores ≥ 2.5 at any site. EBM was further subdivided into moderate EBM (MEBM) with Z-scores between 2.5 and 4.0, and SEBM with Z-scores ≥ 4.0. Demographic data, medical history, and comorbidities were collected and analyzed.

Results

Of the 33,479 eligible participants, 1,472 (4.4%) were identified with EBM. The EBM group was divided into 1,267 (3.8%) with MEBM and 205 (0.6%) with SEBM. SEBM group had a significantly higher proportion of men and a higher BMI than the MEBM group (p < 0.001). In addition, SEBM group had a higher prevalence of conditions such as DISH, ankylosing spondylitis (AS), LDD, and diabetes (p < 0.001). Different correlation trends between BMI, T-scores, and Z-scores were observed in the SEBM and MEBM groups. Chi-squared Automatic Interaction Detection (CHAID) analysis identified DISH as the strongest predictor of SEBM, while severe LDD, increased BMI, and diabetes were contributing factors for SEBM.

Conclusions

Using the modified criteria for EBM, which exclude cases of osteoporosis and osteopenia, SEBM has a higher rate of comorbidities compared to MEBM. The presence of DISH, higher severity of LDD, increased BMI, and diabetes were identified as strong risk factor of SEBM.