Prevalence and Risk Factors of T-Score Spine-Hip Discordance in Patients with Osteoporotic Vertebral Compression Fracture

Byung Ho Yoon, Ho Won Kang, Su Min Kim, Young-Do Koh

Research output: Contribution to journalArticlepeer-review

Abstract

Background: T-score discordance between the spine and hip is commonly observed when dual energy X-ray absorptiometry (DXA) is used to diagnose osteoporosis. However, information is scarce regarding the prevalence and risk factors for this problem in Korea. This study evaluated the prevalence of major/minor discordance and associated risk factors in elderly Korean patients with osteoporotic vertebral compression fractures (OVCFs). Methods: This study included 200 patients (37 men, 163 women) treated for thoracic or lumbar compression fractures between January 2015 and August 2021. DXA was performed to examine T-scores and determine the prevalence of discordance, defined as a difference between the T-score categories of the femur and spine in the same individual. The t-tests, x2tests, and regression analyses were used to assess the associated risk factors of T-score discordance among the subjects. Results: T-score concordance, minor discordance, and major discordance were observed in 137 (68.5%), 59 (29.5%), and 4 (2%) patients with OVCFs, respectively. The spinal T-score was lower than the femoral T-score in all major discordance and 81.3% (48/59) of minor discordant cases. Overall, the only factor related to T-score discordance was the age at fracture (odds ratio, -0.01; P=0.014). Conclusions: The results of this study showed that a significant number of subjects (31.5%) showed spine-hip discordance, even with a mean age in their 80s. More attention should be paid to the appropriate evaluation and management of elderly patients with OVCFs. Moreover, a longitudinal study is necessary to verify the clinical importance of T-score discordance in this population.

Original languageEnglish
Pages (from-to)43-49
Number of pages7
JournalJournal of Bone Metabolism
Volume29
Issue number1
DOIs
StatePublished - Feb 2022

Keywords

  • Absorptiometry, photon
  • Bone density
  • Fractures, compression
  • Osteoporosis
  • Spinal fractures

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