HONOLULU — Men diagnosed with osteopenia through dual-energy x-ray absorptiometry are unlikely to have a change in diagnosis at a 3-year follow-up DXA, according to a study presented at the annual meeting of the American Society for Bone and Mineral Research.
“The interval for a follow-up bone density should be lengthened, or perhaps the repeat DXA should not be done unless there is an additional risk factor noted,” wrote Dr. Robert A. Adler of the endocrinology section of McGuire Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, and colleagues.
The researchers followed 78 men with osteopenia (T score of lumbar spine, femoral neck, total hip, total forearm or distal 1/3 forearm between -1 and -2.4) from a baseline DXA test through follow-up DXA testing an average of 998 days later.
The mean age and weight of the patients at baseline were 70.7 years and 76.4 kg, respectively.
All of the men had been referred for an initial DXA test after a screening program using the Osteoporosis Self-Assessment Tool had found them to be at increased risk for osteoporosis.
Mean percent changes in bone mineral density (BMD) from baseline to follow-up were 1.8% for lumbar spine, -0.4% for femoral neck, -0.7 for total hip, -1.1 for 1/3 radius, and -1.6 for total forearm.
“The BMD changes were minimal, approximately plus or minus 2%,” the researchers noted, and affected diagnosis very rarely: Only one patient started therapy for osteoporosis after the follow-up DXA test because of a significant change in BMD.
Although it was recommended upon diagnosis with osteopenia that the patients take calcium and vitamin D supplements, only about one-fourth to one-third actually received the supplementation after the baseline DXA.
“After the second DXA, an additional 17 men were prescribed supplements,” the researchers pointed out.
Although these results suggest that a second DXA test may encourage clinicians to prescribe such preventive measures as calcium and vitamin D supplements for their patients, “there should be cheaper ways to improve clinician behavior,” the researchers suggested.
Dr. Adler stated that he had no conflicts of interest.