Background T-score discordance is common in osteoporosis diagnosis and leads to problems for clinicians formulating treatment plans. Objectives This study investigated the potential predictors of T-score discordance and compared fracture risk among individuals with varying T-score discordance status. Design This was a single-center cross-sectional study conducted at Wan Fang Hospital, Taipei City, between 1 February 2020 and 31 January 2022. Methods The present study enrolled patients aged ⩾50 years who received advanced bone health examination. Participants with a history of fracture surgery or underlying musculoskeletal diseases were excluded. Bioelectrical impedance analysis and dual-energy X-ray absorptiometry were used to determine the body composition and T-score, respectively. Discordance was defined as different T-score categories between the lumbar spine and hip. The impact of discordance on an individual's fracture risk was assessed using the Fracture Risk Assessment Tool (FRAX). Results This study enrolled 1402 participants (181 men and 1221 women). Of the 912 participants diagnosed with osteoporosis, 47 (5%) and 364 (40%) were categorized as having major and minor discordance, respectively. Multinomial logistic regression revealed that decreased walking speed was significantly correlated with major discordance but not osteoporosis in both the hip and lumbar spine (odds ratio of 0.25, p = 0.04). The adjusted FRAX scores for the major osteoporotic fracture risks of the major and minor discordance groups were approximately 14%, which was significantly lower than that of people having osteoporosis in both the hip and lumbar spine. Conclusions Walking speed exhibited the most significant correlation with major discordance in patients with osteoporosis. Although adjusted major fracture risks were similar between the major and minor discordance groups, further longitudinal studies are warranted to confirm this finding. Registrations This study was approved by the Ethics Committee of Taipei Medical University on 01/04/2022 (TMU-JIRB N202203088).

中文翻译：

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髋部和腰椎之间的 T 分数不一致：危险因素和临床意义。

背景 T 分数不一致在骨质疏松症诊断中很常见，会给临床医生制定治疗计划带来问题。目的 本研究调查了 T 评分不一致的潜在预测因素，并比较了不同 T 评分不一致状态的个体之间的骨折风险。设计 这是一项单中心横断面研究，于 2020 年 2 月 1 日至 2022 年 1 月 31 日在台北市万芳医院进行。 方法 本研究纳入年龄≥50 岁且接受高级骨健康检查的患者。有骨折手术史或潜在肌肉骨骼疾病的参与者被排除在外。生物电阻抗分析和双能X射线吸收测定法分别用于确定身体成分和T分数。不一致被定义为腰椎和髋部之间不同的 T 分数类别。使用骨折风险评估工具（FRAX）评估不一致对个人骨折风险的影响。结果 本研究招募了 1402 名参与者（181 名男性和 1221 名女性）。在 912 名被诊断患有骨质疏松症的参与者中，分别有 47 名 (5%) 和 364 名 (40%) 被归类为存在严重和轻微不一致。多项逻辑回归显示，步行速度降低与髋部和腰椎的主要不一致显着相关，但与骨质疏松症无关（优势比为 0.25，p = 0.04）。主要和次要不一致组的主要骨质疏松性骨折风险的调整后 FRAX 评分约为 14%，显着低于髋部和腰椎同时患有骨质疏松症的人群。结论 步行速度与骨质疏松症患者的主要不一致性表现出最显着的相关性。尽管调整后的主要骨折风险在主要和次要不一致组之间相似，但仍需要进一步的纵向研究来证实这一发现。注册 本研究于 2022 年 1 月 4 日获得台北医学大学伦理委员会批准 (TMU-JIRB N202203088)。