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. 2022 Oct 17;11(20):6114.
doi: 10.3390/jcm11206114.

Prevalence of Osteoporosis Assessed by DXA and/or CT in Severe Obese Patients

Marion Halin  1 , Edem Allado  2   3 , Eliane Albuisson  4   5 , Laurent Brunaud  6   7   8 , Isabelle Chary-Valckenaere  1   9 , Damien Loeuille  1   9 , Didier Quilliot  6   7   10 , Marine Fauny  1   11
Affiliations

Prevalence of Osteoporosis Assessed by DXA and/or CT in Severe Obese Patients

Marion Halin et al. J Clin Med. .

Abstract

The primary objective was to evaluate bone fragility prevalence on dual X-ray absorptiometry (DXA) and computed tomography (CT) in patients with severe obesity. The secondary objective was to evaluate the risk factors for bone fragility. This monocentric study was conducted in patients with grade 2 and 3 obesity. Bone mineral density (BMD) and T-score were studied on DXA, and the scanographic bone attenuation coefficient of L1 (SBAC-L1) was measured on CT. Among the 1386 patients included, 1013 had undergone both DXA and CT within less than 2 years. The mean age was 48.4 (±11.4) years, 77.6% were women, and the mean BMI was 45.6 (±6.7) kg/m². Eight patients (0.8%) had osteoporosis in at least one site. The mean SBAC-L1 was 192.3 (±52.4) HU; 163 patients (16.1%) were under the threshold of 145 HU. Older age (OR[CI95] = 1.1 [1.08-1.16]), lower BMD on the femoral neck and spine (OR[CI95] = 0.04[0.005-0.33] and OR[CI95] = 0.001[0.0001-0.008], respectively), and higher lean mass (OR[CI95] = 1.1 [1.03-1.13]) were significantly associated with an SBAC-L1 ≤ 145 HU in multivariate analysis. Approximately 16% of patients with severe obesity were under the SBAC-L1 threshold, while less than 1% were classified as osteoporotic on DXA.

Keywords: bone mineral density (BMD); dual-energy X-ray absorptiometry (DXA); obesity; scanographic bone attenuation coefficient (SBAC-L1); tomodensitometry/CT.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart. CT: computed tomography; DXA: dual-energy X-ray absorptiometry.
Figure 2
Figure 2
Distribution of patients with VF according to the bone fragility assessment method (SBAC-L1 ≤ 145 HU for A and C and T-score ≤ −2.5 SD for B). DXA: dual-energy X-ray absorptiometry; CT: computed tomography; SBAC-L1: Scanographic bone attenuation coefficient. (A): Distribution of patients with VF according to the SBAC-L1 threshold (CT evaluation). (B): Distribution of patients with VF according to the femoral neck T-score (DXA evaluation). (C): Distribution of SBAC-L1 for patients with or without VF.
See this image and copyright information in PMC

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