Patterns of age- and sex-related variations in bone mineral density of total spine by selected demographic and socioeconomic variables

Research Objectives: Bone mineral density (BMD) is a measure of the amount of minerals present in bone. A decrease in BMD in the spine, known as osteoporosis, can increase the risk of vertebral fractures. This study aimed to examine the patterns of age- and sex-related variations in BMD of total spine among U.S. residents by selected demographic and socioeconomic variables.

Design: This is an observational study.

Setting: General community.

Participants: Total spine BMD, taken from 20,644 noninstitutionalized participants, aged 6 to 80, were obtained from the National Health and Nutrition Examination Survey (NHANES) study. We described the age-related change of total spine BMD across the life span in four distinct cross-sectional surveys during 2005-2008, 2009-2012, 2013-2016, and 2017-2020, and compared the total spine BMD by sex, survey year, race/ethnicity, education, poverty level, and history of ever served on active duty. Last, we computed the percentage change per year of the total spine BMD by sex.

Interventions: N/A

Main Outcome Measures: Dual Energy X-ray Absorptiometry - Spine.

Results: The means of spine BMD were lower for younger children, gradually increased to reach a plateau in early adult life, peaked around 19-50 years old, and then gradually declined onwards. Females had declined spine BMD after menopause. The mean of total spine BMD in females was 114% of that of males in age 12-15 years old, 100% of that of males in middle adult age, and 85% of that of males 70-80+ years older. Being male, being non-Hispanic black, having an educational level of at least high school and higher, having an income higher than the poverty level, and has served on active duty in the US armed forces, were associated with higher total spine BMD levels (p < 0.001).

Conclusions: Between 2005 and 2020, stable trends in total spine BMD values were observed among noninstitutionalized residents in the US. Targeted educational efforts are warranted to enhance knowledge of personal risk indicators.

Author(s) Disclosures: The authors declare no conflict of interest.