Intervertebral T-Score Differences in Younger and Older Women |
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| Authors: | Glen M. Blake Edward Noon Tim D. Spector Ignac Fogelman |
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| Affiliation: | 1. Osteoporosis Research Unit, King''s College London, King''s Health Partners, Guy''s Hospital, London, UK;2. Department of Twin Research and Genetic Epidemiology, King''s College London, King''s Health Partners, St Thomas'' Hospital, London, UK;1. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA;2. Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA;1. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milano, Italy;2. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy;3. Servizio di Radiologia, IRCCS Policlinico San Donato, San Donato Milanese, Italy;4. Servizio di Fisica Sanitaria, Fondazione IRCCS Ca'' Granda - Ospedale Maggiore Policlinico, Milano, Italy;5. Mineralometria Ossea Computerizzata e Ambulatorio Malattie Metabolismo Minerale e Osseo, Servizio di Medicina Nucleare, Fondazione IRCCS Ca'' Granda - Ospedale Maggiore Policlinico, Milano, Italy;1. University of California Berkeley–UCSF Graduate Program in Bioengineering, San Francisco, CA, USA;2. Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA;1. Adult/Acute Health, Chronic Care and Foundations, UAB School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA;2. UAB Osteoporosis Prevention and Treatment Clinic, The University of Alabama at Birmingham, Birmingham, AL, USA;3. Division of Clinical Immunology and Rheumatology, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA;1. Cleveland Clinic Center for Human Nutrition, Cleveland, OH, USA;2. Department of Endocrinology, Diabetes, and Metabolism, Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA |
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| Abstract: | The T-score discordance among skeletal sites is an important aspect of dual-energy X-ray absorptiometry (DXA) measurements. In the spine, large T-score differences between vertebrae are frequently seen in elderly patients owing to degenerative disease. However, it is unclear how often such differences occur in younger adults with healthy spines.The T-scores for individual lumbar vertebrae were compared for 2391 female singletons (18–79 yr) recruited to the Twins UK Adult Twin Register. Women were divided into 6 age bands and 5 bands by body weight, respectively, and the T-score differences between the pairs of vertebrae were examined using correlation coefficients and the standard error of the estimate (SEE) from linear regression analysis.Correlations between the T-scores for adjacent lumbar vertebrae were r = 0.92 decreasing to r = 0.79 between L1 and L4. When plotted as a function of age, r-values were constant for the 5 younger age bands, but decreased in the oldest group. In contrast, the T-score SEE values increased progressively with age from 0.4 to 0.5 for the younger groups to 0.7 for the oldest. Similar trends were seen when women were divided according to body weight. Both increasing age and higher body weight were statistically significantly associated with a higher T-score SEE.The incidence of large T-score differences between vertebrae varies with age and body weight, but is common even among younger women. Clinically significant T-score differences can occur in the absence of osteoarthritis, and visual assessment of spine DXA scans for evidence of degenerative disease is advised before vertebrae are omitted from scan analyses. |
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