Original article| Volume 102, ISSUE 4, P637-645, October 1983

Total body calcium by neutron activation analysis in normals and osteoporotic populations: a discriminator of significant bone mass loss

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      This paper reports total body calcium by neutron activation (TBC) measurements in 94 normal individuals and 86 osteoporotic patients. The ability of TBC to discriminate normal from osteoporotic females was evaluated with decision analysis. Bone mineral content (BMC) by single-photon absorptiometry was also measured. TBC was higher in males (range 826 to 1363 gm vs 537 to 1054 in females) and correlated with height in all normals (r = 0.55 in males, 0.58 in females; p < 0.001). In females over age 55 there was a negative correlation with age (r = −0.51, p < 0.01). Thus, for normals an algorithm was derived to allow comparison between measured TBC and that predicted by sex, age, and height (TBCp). In the 28 normal females over age 55, the TBC was 764 ± 115 gm vs. 616 ± 90 in the osteoporotics (p < 0.001). In 63 of the osteoporotic females an estimated height, from tibial length, was used to predict TBC. In normals the Math Eq ratio was 1.00 ± 0.12, whereas in osteoporotic females it was 0.80 ± 0.12 (p < 0.001). A receiver operating characteristic curve showed better discrimination of osteoporosis with Math Eq than with wrist BMC. By using Bayes' theorem, with a 25% prevalence of osteoporosis (estimate for postmenopausal women), the posttest probability of disease was 90% when the Math Eq ratio was less than 0.84. We conclude that a low Math Eq ratio is very helpful in determining osteoporosis.


      total body calcium ((TBC)), total body calcium predicted by height sex and age ((TBCp)), bone mineral content ((BMC)), receiver operating characteristic curve ((ROC curve))
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