Doctor reminds: Except for four types of people, no one else needs to do a bone density test!

Expert of this article: Wang Qin, Endocrinologist and Metabolism, West China Hospital, Sichuan University

Many people understand that if calcium deficiency, children are easy to grow tall, and middle-aged and elderly people are prone to fractures. In order to understand whether the calcium in your bones is enough and whether the bone strength is good, the amount of bone contained in the bone, that is, bone density, is an important judgment indicator.

Bone density tests are not done by everyone

In fact, the following two types of people really do not need to do routine bone density tests.

1. The vast majority of adolescents and children

Whether it is a baby just a few months old, or a school-age child or teenager, most of them really do not need to go for a bone density test.

First of all, there is no bone density database on children and adolescents at home and abroad, and the results made by children can only be compared with the database of adults over 20 years old, but in fact, due to growth and development, children's bone density is lower than that of normal adults, which may mislead some parents.

Secondly, bone density and calcium deficiency are not equated. The staple food of children under the age of 1 is milk, whether drinking breast milk or formula milk, it is rich in calcium, so as long as you get enough vitamin D at the same time (the child protection doctor generally makes the child supplement), it is difficult for children at this stage to lack calcium, so there is no need to do routine bone density tests.

Finally, the child's height is not only determined by calcium, but also by genetics, balanced nutrition, exercise, environment and other factors.

Therefore, except for those children who have had repeated fractures, bone deformities, etc., or who need to monitor bone density for a long time to take certain drugs and carry out certain treatments, ordinary children really do not need to do it.

2. Nutritionally balanced young people

Young people in their twenties and thirties who are in good health, have balanced nutritional intake, generally stable work and rest, and are healthy, especially those who love to exercise, do not need to add bone density tests to their annual physical examination items.

This is because the occurrence of osteoporosis has a lot to do with age, human bone mass peaks around the age of 30, and then decreases with age, especially women will accelerate the decline after menopause, so healthy, nutritionally balanced young people in their twenties and thirties do not have to worry about osteoporosis.

Four types of talents need to do bone density examination

Bone density tests can indeed reflect the health of bones and play an important role in preventing fractures, so in addition to people who need regular monitoring of bone density due to disease treatment, these people need to do (or do regularly) bone density tests:

1. Women over 65 years old, men over 70 years old

A bone density test should be done as a baseline, and treatment should be decided based on the results after a specialist visit, and a follow-up should be arranged later according to the situation.

2. People with osteoporosis symptoms

Women between the ages of 65 and men between the ages of 50 and 70 who have more than one risk factor for fractures, especially with osteoporosis symptoms, need to have bone density testing.

These symptoms include: low back pain and discomfort after activity, bending, and weight bearing, which are relieved after rest; The height is more than 3 cm lower than when I was younger, or there is a hunched back, a decrease in mobility, such as feeling that the legs are weak and climbing upstairs.

3. Those over 50 years of age who have developed a fracture

Fractures of any cause have occurred over the age of 50.

4. People who have diseases that cause low bone mass or bone loss

Those under the above age who have a medical condition that causes low bone mass or bone loss (such as autoimmune diseases such as rheumatoid arthritis, diseases that affect digestion and absorption, kidney disease, neuromuscular disease, etc.) or take medications that cause low bone mass or bone loss.

Body fat scale, ultrasonic bone density

Osteoporosis cannot be judged

In the outpatient clinic, many people tell the doctor that they have osteoporosis when they come to the doctor. Ask carefully, either the body fat scale indicates that the "bone salt amount" is low, or the result of ultrasound bone density examination.

Neither of these "results" means that you have osteoporosis.

1. The "bone salt amount" of the body fat scale is not accurate

The "amount of bone salt" in the body fat scale does not refer to the weight of the bone, but the weight of the bone tissue in the bone such as calcium, phosphorus, and bone matrix, etc., in theory, this indicator can simply reflect the health of the bone, if the "bone salt amount" is low, it means that there may be a risk of osteoporosis. But this is only theoretical.

The body fat scale uses the principle of "resistance measurement" and the characteristics of fat that is not easy to conduct electricity, combined with formulas and algorithms, as well as the user's height, weight, age and other information, and comprehensively calculates a series of data. These data will change according to factors such as the user's drinking water, usage method, and ambient temperature. In addition, some people with a height of 178 cm lose 180 cm on the body fat scale, and a gap of 2 cm may cause a change in the result value.

The detection of body fat scale has a very limited response to bone mass, and cannot be used as a screening method for osteoporosis, let alone as a diagnostic basis.

2. Ultrasound bone density is only a screening tool

Ultrasound bone density is a commonly used medical test. Only need to measure the heel or fingers, carpal bones, etc., to get a preliminary indicator, if this indicator is lower than normal, then osteoporosis may be suspected.

Note that ultrasound bone density test is only a screening method for osteoporosis, if it is made to indicate osteopenia or even osteoporosis, you need to go to a regular hospital for professional bone density examination! However, in people with osteoporosis, ultrasound bone density may also be normal.

Diagnosis of osteoporosis

This inspection is the gold standard

For people who may have osteoporosis, doctors will prescribe a more professional bone density test, dual-energy X-ray absorptiometry, also known as DXA, which is the "gold standard" for diagnosing osteoporosis.

Using low-dose X-rays to reflect the amount (density) of different body components through the difference in energy after different tissues is not only needed to diagnose osteoporosis, but also the gold standard for reflecting body fat and lean tissue (such as muscle mass).

Special reminder: bone density is the need to check the waist and hips, if only one of the parts is examined, osteoporosis may be missed.

Also, be sure to see a specialist to see the results. Even if the value of the test seems to be within the normal range, the doctor will make a comprehensive judgment based on your symptoms, disease history, family history, etc., to see if you need treatment.

Bibliography:

1. Osteoporosis and Bone Mineral Disease Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of primary osteoporosis (2022)[J]. Chinese Journal of General Practice, 2023, 26(14): 1671-1691. DOI: 10.12114/j.issn.1007-9572.2023.0121.

2. Kalkwarf HJ, Abrams SA, DiMeglio LA, Koo WWK, Specker BL, Weiler H., Bone Densitometry in Infants and Young Children: The 2013 ISCD Pediatric Official Positions. Journal of Clinical Densitometry, 2014; 17(2):243–257.

3. Laura K. Bachrach, Catherine M. Gordon, SECTION ON ENDOCRINOLOGY, Bone Densitometry in Children and Adolescents, Pediatrics, 2016; 138(4):e20162398.

This article was first published on:2023-06-12 West China Hospital of Sichuan University "West China Doctor said that in addition to these four types of people, other people do not need to do bone density tests! , the content is slightly deleted, and the copyright belongs to the original author.

Source: Health Times