摘要
2003年,国际临床骨密度学会(ISCD)发布官方立场:世界卫生组织(WHO)骨密度分类标准不仅限定在绝经后妇女中应用,也可以扩展应用于人口总体中。但是,对绝经前女性、男性和非白种人群骨密度分类的应用,这一文件并没有完全诠释清楚。2005年召开ISCD共识发展大会,ISCD专家组成员同ISCD专业顾问委员会一起重新讨论了这些主题,并依据严密、可靠、最新的数据资料回顾,进一步准确清晰地从以下方面确定了2005年ISCD官方立场。(1)‘骨量减少’(osteopenia)术语的通用性;(2)骨密度报告中T值和Z值的适用范围;(3)什么年龄范围适用于WHO骨密度分类标准;(4)哪一个正常数据库可适用于非白种人群。概括地说,可以继续使用术语‘骨量减少’(Osteopenia),但应首选‘低骨量’(low bone mass)或‘低骨密度’(low bone density)。对绝经前女性和50岁以下男性,首选Z值(不是T值)。等于或低于-2.0的Z值定义为“低于该年龄预期值范围以下”,大于-2.0以上的Z值则定义为“处于该年龄预期值范围以内”。在绝经后女性和≥50岁男性中,T值首选,适用WHO的分类标准。下面行文将对这些正式立场的理论基础和依据展开讨论。
In 2003, the International Society for Clinical Densitometry （ISCD） developed Official Positions regarding the applicability of the World Health Organization（WHO） classification of bone mineral density of bone mineral density to populations other than postmenopausal women. However, these prior Official Positions do not fully address bone mineral density reporting in females prior to menopause, men, and non-whites. During the 2005 ISCD Position Development Conference, members of the ISCD Expert Panel in conjunction with the ISCD Scientific Advisory Committee re-addressed these topics and, based upon stringent reviews of best available data, developed ISCD Official Positions that provide greater specificity and clarification with respect to the following：（ 1 ）the utility of the term ＇osteopenia＇ ;（2）utilization of T- and Z-scores for bone mineral density reporting;（3）when to apply the WHO densitometric classification;and （4） which normative database（s） should be used for non-white individuals. Briefly,the term ＂Osteopenia＂ is retained,but ＇low bone mass＇ or ＇low bone density＇ is preferred. Z-scores, not T- scores, are preferred in females prior to menopause and males under age 50. In these individuals, a Z-score of - 2. 0 or lower is defined as ＂below the expected range for age＂ and a Z-score above - 2.0 is ＂within the expected range for age.＂ T-scores are preferred and the WHO classification is applicable for postmenopaasal women and men age 50 and older. These Official Positions, rationale and evidence are discussed in the following report.
出处
《中国骨质疏松杂志》
CAS
CSCD
2007年第3期208-216,共9页
Chinese Journal of Osteoporosis
