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<p>Older men suffer from hip FFx (fragility fracture) at femoral neck <i>T</i>-score approximately 0.6 higher than older women, thus we proposed a new category of low BMD status, osteofrailia, for older Caucasian men with femoral neck <i>T</i>-score ≤ −2.0 (<i>T</i>-score ≤ −2.1 for older East Asian men) who have an increased risk of hip FFx. Around the age of 78&#xa0;years, mean LS (lumbar spine) QCT BMD is around 68&#xa0;mg/mL and 100&#xa0;mg/mL for East Asian men and Caucasian men, respectively. For East Asian men, LS QCT BMD &lt;68&#xa0;mg/mL offers a sensitivity of 77% for detecting vertebral FFx cases, which is consistent with LS QCT BMD &lt;80&#xa0;mg/mL and &lt; 50&#xa0;mg/mL offering a vertebral FFx detection sensitivity of around 77% for Caucasian women and East Asian women, respectively. For Chinese men, <i>T</i>-score ≤ −2.5 predicts hip FFx risk better than other <i>T</i>-score values, and LS DXA <i>T</i>-score − 2.5 corresponds to QCT BMD 68&#xa0;mg/mL. Hip FFx occur at approximately 0.5 LS <i>T</i>-score higher in Caucasian men than in Caucasian women. Among older Caucasian populations, for the separation of patients with FFx and without FFx, QCT BMD &lt;100&#xa0;mg/mL in older men is approximately comparable to &lt;80&#xa0;mg/mL in older women. For FFx risk prediction, we propose osteofrailia threshold LS DXA <i>T</i>-score to be ≤ − 2.5 and ≤ −2.0, and QCT BMD to be &lt;68&#xa0;mg/mL and &lt; 100&#xa0;mg/mL, respectively, for East Asian men and Caucasian men. The relationship between LS QCT BMD and hip FFx risk should be better investigated in the future.</p>

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Lumbar spine DXA T-score and QCT BMD cutpoint values for defining osteofrailia among older men: a framework for further refinement

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月23日

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  • Yì Xiáng J. Wáng,
  • Timothy C. Y. Kwok,
  • Maria Pilar Aparisi Gómez,
  • Ben-Heng Xiao,
  • Jason C. S. Leung,
  • Fernando Ruiz Santiago,
  • Wing P. Chan,
  • Daniele Diacinti,
  • Ali Guermazi,
  • Alberto Bazzocchi

摘要

Older men suffer from hip FFx (fragility fracture) at femoral neck T-score approximately 0.6 higher than older women, thus we proposed a new category of low BMD status, osteofrailia, for older Caucasian men with femoral neck T-score ≤ −2.0 (T-score ≤ −2.1 for older East Asian men) who have an increased risk of hip FFx. Around the age of 78 years, mean LS (lumbar spine) QCT BMD is around 68 mg/mL and 100 mg/mL for East Asian men and Caucasian men, respectively. For East Asian men, LS QCT BMD <68 mg/mL offers a sensitivity of 77% for detecting vertebral FFx cases, which is consistent with LS QCT BMD <80 mg/mL and < 50 mg/mL offering a vertebral FFx detection sensitivity of around 77% for Caucasian women and East Asian women, respectively. For Chinese men, T-score ≤ −2.5 predicts hip FFx risk better than other T-score values, and LS DXA T-score − 2.5 corresponds to QCT BMD 68 mg/mL. Hip FFx occur at approximately 0.5 LS T-score higher in Caucasian men than in Caucasian women. Among older Caucasian populations, for the separation of patients with FFx and without FFx, QCT BMD <100 mg/mL in older men is approximately comparable to <80 mg/mL in older women. For FFx risk prediction, we propose osteofrailia threshold LS DXA T-score to be ≤ − 2.5 and ≤ −2.0, and QCT BMD to be <68 mg/mL and < 100 mg/mL, respectively, for East Asian men and Caucasian men. The relationship between LS QCT BMD and hip FFx risk should be better investigated in the future.