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Opportunistic screening using low-dose CT and the prevalence of osteoporosis in China : a nation-wide, multicenter study.

Xiaoguang, C. and Kai Ping, Z. and Xiaojuan, Z. and Xia, D. and Yongli, L. and Shuang, C. and Yan, W. and Shao Lin, L. and Yong, L. and Yuqin, Z. and Xigang, X. and YueHua, L. and Xiao, M. and Xiangyang, G. and Wei, C. and Yingying, Y. and Jun, J. and Bairu, C. and Yinru, L. and Jianbo, G. and Guo Bin, H. and Yaling, P. and Yan, Y. and Hiujuan, Q. and Limei, R. and Jian, Z. and Ling, W. and Kai, L. and Haihong, F. and Jing, W. and Shiwei, L. and Blake, G.M. and Pickhardt, P. and Yuanzheng, M. and Xiaoxia, F. and Shengyong, D. and Qiang, Z. and Zhiping, G. and Hind, K. and Wei, T (2021) 'Opportunistic screening using low-dose CT and the prevalence of osteoporosis in China : a nation-wide, multicenter study.', Journal of bone and mineral research., 36 (3). pp. 427-435.

Abstract

Opportunistic screening for osteoporosis can be performed using low‐dose computed tomography (LDCT) imaging obtained for other clinical indications. In this study we explored the CT‐derived bone mineral density (BMD) and prevalence of osteoporosis from thoracic LDCT in a large population cohort of Chinese men and women. A total of 69,095 adults (40,733 men and 28,362 women) received a thoracic LDCT scan for the purpose of lung cancer screening between 2018 and 2019, and data were obtained for analysis from the China Biobank Project, a prospective nationwide multicenter population study. Lumbar spine (L1–L2) trabecular volumetric bone mineral density (vBMD) was derived from these scans using quantitative computed tomography (QCT) software and the American College of Radiology QCT diagnostic criteria for osteoporosis were applied. Geographic regional differences in the prevalence of osteoporosis were assessed and the age‐standardized, population prevalence of osteoporosis in Chinese men and women was estimated from the 2010 China census. The prevalence of osteoporosis by QCT for the Chinese population aged >50 years was 29.0% for women and 13.5% for men, equating to 49.0 million and 22.8 million, respectively. In women, this rate is comparable to estimates from dual‐energy X‐ray absorptiometry (DXA), but in men, the prevalence is double. Prevalence varied geographically across China, with higher rates in the southwest and lower rates in the northeast. Trabecular vBMD decreased with age in both men and women. Women had higher peak trabecular vBMD (185.4 mg/cm3) than men (176.6 mg/cm3) at age 30 to 34 years, but older women had lower trabecular vBMD (62.4 mg/cm3) than men (92.1 mg/cm3) at age 80 years. We show that LDCT‐based opportunistic screening could identify large numbers of patients with low lumbar vBMD, and that future cohort studies are now required to evaluate the clinical utility of such screening in terms of fracture prevention and supporting national health economic analyses.

Item Type:Article
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Status:Peer-reviewed
Publisher Web site:https://doi.org/10.1002/jbmr.4187
Publisher statement:© 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Date accepted:17 September 2020
Date deposited:10 November 2020
Date of first online publication:04 November 2020
Date first made open access:10 November 2020

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