| Objective The goals of this study are to establish the Chinese spinal QCT vBMD reference database, and to validate the diagnosis criteria of osteoporosis with QCT for Chinese. Methods This study consisted of three cohorts, (1) 1584 healthy young adults of 20-40 years old from multi centers across China, (2) 3420 healthy subjects of 40-83 years old from communities, and (3) 432 cases of osteoporotic spinal fractures admitted and treated in our hospitals. The lumbar spine volumetric bone mineral density (vBMD) of the L1-2 vertebral bodies was measured with Mindways QCT pro, and the average value of L1-2 was calculated. The international QCT diagnosis criteria for osteoporosis were used, i.e., osteoporosis, BMD < 80mg/cm3; osteopenia, BMD 80-120mg/cm3; and normal, BMD > 120 mg/cm3. The CT lateral scoutview images of community subjects were reviewed by experienced radiologists to score the vertebral fractures according to Genant’s SQ method for T4- L4, Grade 0 for normal, 1 for mild, 2 for moderate, and 3 for severe fracture. The subjects were classified as fracture if one vertebral score ≥1, and the highest score was considered the severity of the individual subject. X-ray, CT, and/or MRI were performed for the fracture patients, and at least one fracture was found. SPSS 19.0 was used for statistical analysis. Results The average BMD of the lumbar vertebrae in 20-40 years old males was 163.26±28.82 mg/cm3, which was lower than that in females 174.45±29.24 mg/cm3 (P<0.001). From 50 to 80 years old, BMD in females was lower than in males (P< 0.05). For 3420 subjects of 40-83 years old community population, 33.2 % of them had normal BMD (>120mg/cm3), 38.3% were osteopenia (80-120mg/cm3), and 28.5% were osteoporosis (<80mg/cm3). The prevalence of the spinal fracture in the normal, osteopenia, and osteoporosis population was 7.14%, 14.6%, and 30.63%, respectively. It showed a doubled correlation. In 432 patients with spinal fractures, 86% of them had BMD < 80mg/cm3, and 14% between 80-120 mg/cm3. Conclusion In this study, we establish the normal reference database of QCT for Chinese, which provide the basis for QCT application. Our results demonstrate that the international QCT diagnosis criteria for osteoporosis are applicable for Chinese population. |