The reference mean of bone mineral density in egyptian women

Abstract EN

Background: Osteoporosis is a disease characterized by low bone mass and the development of non-traumatic or atraumatic fractures as a direct result of such low bone mass.

Bone densitometry has become an established tool for diagnosing and following up patients with low bone mineral density.

Bone densitometry machines measure the bone mineral content in a certain region.

The obtained value is then compared via computerized software to the normal population reference mean.

Study design: This is a cross sectional study aiming to determine the bone mineral density of the Egyptian reference women population in comparison to other reference populations (European/USA and Lebanese).

It also aimed at detecting the prevalence of osteopenia and osteoporosis in Egyptian women according to the WHO definition based on a curve derived from the bone mineral density of an Egyptian reference sample population instead of the American /Europe curve currently used in practical diagnosis.

Methods: We studied 1253 cases fulfilling the criteria of inclusion as reference populations.

Cases were stratified into 7 categories each representing a decade.

The Bone Mineral density values were obtained through Dual Energy X-ray Absorptiometry (DEXA) measurements at the lumbar spines, femoral neck and radius.

The obtained values were subjected to regression analysis according to age and were compared to values for other reference populations Results: The collected data were adequate for the establishment of a curve of the Egyptian reference women population at the three major sites: lumbar spine at L2-L4, the femur at the femoral neck and the radius at its ultradistal end.

In general, the Egyptian curve has the same regions as the standard American/European curve.

However Egyptian females have a lower BMD at all the measured sties.

The spine BMD at L-2, L3 and L4 was found to be 93.26%, 94.11% and 96.82 % of the corresponding regions of the American European curve.

The femoral neck values were again 97.52%, 97.52% and 94.69% of the corresponding regions of the American/European curve.

At the ultradistal end of the radius, the Egyptian BMD values were 92.3% and 91.75% of the corresponding regions of the American/European curve.

The prevalence of osteopenia and osteoporosis was evaluated according to the American/ European as well as the established Egyptian young adult standard values.

Applying the Egyptian standards resulted in a significantly lower prevalence of osteopenia and osteoporosis in L2-L4 and ultradistal end of the radius at several age strata.

On the other hand at the femoral neck, a higher prevalence of osteopenia and osteoporosis was encountered, which was only significant at the seventh decade.

Conclusion: Having a national standard for the diagnosis of osteoporosis gives a better estimate of the size of the problem than using a foreign population reference standard.

Egyptian females have a lower peak BMD compared to the USA/European standards.

This low value is maintained with variable degrees in all age strata throughout all measured sites.