2023, Vol. 27 ›› Issue (13): 2081-2086

Bone mineral density difference in bilateral femoral necks measured by dual-energy X-ray absorptiometry and its influencing factors

Yin Yuping1, Liu Jiachen1, Guo Ningning1, Li Chuangquan1, Liu Xiuwen1, Zhang Shukang1, Lin Xueqing1, Tang Wei1, Chen Shaoxiong1, Liu Xingguang1, Wu Guixia1, Li Long2, Liu Jing3, Zhang Hong1   

Abstract: BACKGROUND: Coping with osteoporosis is an important part of China's response to population aging. Early prevention, early detection and early intervention of osteoporosis were considered to play a very important role in improving prognosis.
OBJECTIVE: To analyze the relevant factors affecting the difference in bone mineral density of bilateral proximal femur and to explore the methods to improve the diagnostic performance of dual-energy X-ray absorptiometry.
METHODS: The clinical data of 207 subjects who underwent dual-energy X-ray absorptiometry bone mineral density examination in Department of Nuclear Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January to July 2021 were retrospectively analyzed. After grouping, differences between groups and related factors leading to differences were analyzed. Multivariate Logistic Regression Equation was utilized for correction. Receiver operating characteristic curve was used to predict performance.
RESULTS AND CONCLUSION: (1) There was no significant correlation between the differences in the bone mineral density of the bilateral femoral necks (higher than the least significant change) and left-right handedness, sleep orientation preference (all P > 0.05). (2) For postmenopausal women and men over the age of 50 years, when the left femoral neck T value was -0.9 or -1.0 (the difference between the bone mineral density value and the bone mineral density value when the T value was -1.1 was greater than the least significant change), the right-side examination could significantly improve the diagnosis rate of osteopenia (P < 0.001). Multivariate logistic regression analysis showed that it was an independent influencing factor after correcting traditional factors, OR=0.001, 95%CI (0.000-0.326), P=0.03; receiver operating characteristic curve predicted its efficacy in altering the diagnosis: area under the curve=0.765, 95%CI (0.536-0.993), P=0.018. (3) It is concluded that for postmenopausal women and men over 50 years old, when the T value of the left femoral neck was -0.9 or -1.0 (the difference between the bone mineral density value and the bone mineral density value when the T value was -1.1 was greater than the least significant change), the dual-energy X-ray absorptiometry bone density test of the lumbar spine and bilateral proximal femur could significantly improve the diagnosis rate of bone loss compared with the lumbar and left side examination.
Key words: dual-energy X-ray absorptiometry, bone mineral density, bone loss, osteoporosis, bilateral proximal femur