Abstract Older men suffer from hip FFx (fragility fracture) at femoral neck T -score approximately 0.6 higher than older women, thus we proposed a new category of low BMD status, osteofrailia, for older Caucasian men with femoral neck T -score ≤ −2.0 ( T -score ≤ −2.1 for older East Asian men) who have an increased risk of hip FFx. Around the age of 78 years, mean LS (lumbar spine) QCT BMD is around 68 mg/mL and 100 mg/mL for East Asian men and Caucasian men, respectively. For East Asian men, LS QCT BMD <68 mg/mL offers a sensitivity of 77% for detecting vertebral FFx cases, which is consistent with LS QCT BMD <80 mg/mL and < 50 mg/mL offering a vertebral FFx detection sensitivity of around 77% for Caucasian women and East Asian women, respectively. For Chinese men, T -score ≤ −2.5 predicts hip FFx risk better than other T -score values, and LS DXA T -score − 2.5 corresponds to QCT BMD 68 mg/mL. Hip FFx occur at approximately 0.5 LS T -score higher in Caucasian men than in Caucasian women. Among older Caucasian populations, for the separation of patients with FFx and without FFx, QCT BMD <100 mg/mL in older men is approximately comparable to <80 mg/mL in older women. For FFx risk prediction, we propose osteofrailia threshold LS DXA T -score to be ≤ − 2.5 and ≤ −2.0, and QCT BMD to be <68 mg/mL and < 100 mg/mL, respectively, for East Asian men and Caucasian men. The relationship between LS QCT BMD and hip FFx risk should be better investigated in the future.
Wáng et al. (Fri,) studied this question.