Effects of age and body mass index on thoracolumbar spine X-ray for diagnosing osteoporosis in elderly women: Tianliao old people (TOP) study 07

Yin Fan Chang, Chin Sung Chang, Mei Wen Wang, Chun Feng Wu, Chuan Yu Chen, Hsuan Jui Chang, Po Hsiu Kuo, Chih Hsing Wu

Research output: Contribution to journalArticle

2 Citations (Scopus)


Purpose: The aim of this study was to determine the effects of diagnostic discordance with or without a thoracolumbar spine lateral view X-ray in patients with osteoporosis. Methods: We randomly enrolled 368 women over 65 years old (74.3 ± 6.0 years) from Tianliao Township in 2009 (response rate: 75.7%). A diagnosis of osteoporosis was confirmed using one of these criteria: (1) a history of non-traumatic fracture, (2) vertebral fractures based on a thoracolumbar spine lateral view X-ray, or (3) a bone mineral density T-score ≤ -2.5 for the total hip, the femoral neck, the lumbar spine, or all 3 sites. The prevalence of osteoporosis in three groups was compared based on Model I (criteria 1+2) vs. Model II (criteria 1+3) vs. Model III (criteria 1+2+3). The role of thoracolumbar X-ray reflected by the diagnostic discordance of osteoporosis between Models II and III was evaluated. Results: The overall prevalence of osteoporosis was 78.3%(Model III, age-standardized 78.1%). The diagnostic discordance was 17.4% in the 368 participants. A logistic regression model showed that age was negatively associated with diagnostic discordance (odds ratio [OR] = 0.93, 95% confidence interval [CI]: 0.88-0.98, p < 0.05), but body mass index was positively associated (OR = 1.07, 95% CI: 1.00-1.15, p < 0.05). Conclusions: A thoracolumbar spine lateral view X-ray should be added for women ≥ 65 years old or with a body mass index ≥ 25 kg/m2 to minimize the diagnostic discordance in osteoporosis, especially in highly endemic regions.

Original languageEnglish
Article numbere0161773
JournalPloS one
Issue number9
Publication statusPublished - 2016 Sep


All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this