The impact of GE Lunar vs ICMR database in diagnosis of osteoporosis among South Indian subjects

• Published in: Indian journal of endocrinology and metabolism Vol. 23; no. 5; pp. 525 - 528
• Main Authors: Balachandran, Karthik, Asirvatham, AdlyneReena, Mahadevan, Shriraam
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.09.2019; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Agreements; Analysis; Bone density; Classification; dexa; Fractures; frax; icmr reference; Medical diagnosis; Medical research; normative data; Original; osteopenia; Osteoporosis; Patients; reference standard; Women; India; United States > US; osteopenia; FRAX; DEXA; normative data; ICMR reference; reference standard; osteoporosis
• ISSN: 2230-8210; 2230-9500
• DOI: 10.4103/ijem.IJEM_142_19

To study the effect of choosing ICMR reference values on the classification of bone mineral density in Indian patients. Retrospective analysis of Dual Energy X-ray absorptiometry (DEXA) and clinical data. Totally, 316 patients aged more than 65 years attending a tertiary care hospital in South India who underwent DEXA scan were included in the study. DEXA scan at femoral neck and lumbar spine. A total of 316 patients were studied. The mean age was 61.98 ± 7.66 years. There were 46.84% females and 53.16% males. The average BMI was 26.37 ± 4.51. Of these patients, 46 had history of hip fracture (14.55%). The adoption of the ICMR normative data resulted in a significant increase in T scores in both the hip (+0.51, < 0.05) and the spine (+1.64, < 0.01). The adoption of ICMR normative values, resulted in reduction of osteoporosis prevalence from 26.58% to 5.06%. There is a clinically significant reduction in diagnosis of osteoporosis with the adoption of ICMR reference standard. Clinicians should be recommended to use raw BMD values in gm/cm in FRAX calculation and avoid the use of T scores, to avoid overestimation of fracture risk. If our results are replicated, the implications are enormous - Osteoporosis is currently being over diagnosed.