Clinical Interventions in Aging Dovepress Bfh-ost, a New Predictive Screening Tool for Identifying Osteoporosis in Postmenopausal Han Chinese Women

hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms Purpose: To develop a simple new clinical screening tool to identify primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in postmenopausal women and to compare its validity with the Osteoporosis Self-Assessment Tool for Asians (OSTA) in a Han Chinese population. Methods: A cross-sectional study was conducted, enrolling 1,721 community-dwelling post-menopausal Han Chinese women. All the subjects completed a structured questionnaire and had their bone mineral density measured using DXA. Using logistic regression analysis, we assessed the ability of numerous potential risk factors examined in the questionnaire to identify women with osteoporosis. Based on this analysis, we build a new predictive model, the Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OST). Receiver operating characteristic curves were generated to compare the validity of the new model and OSTA in identifying postmenopausal women at increased risk of primary osteoporosis as defined according to the World Health Organization criteria. Results: At screening, it was found that of the 1,721 subjects with DXA, 22.66% had osteo-porosis and a further 47.36% had osteopenia. Of the items screened in the questionnaire, it was found that age, weight, height, body mass index, personal history of fracture after the age of 45 years, history of fragility fracture in either parent, current smoking, and consumption of three of more alcoholic drinks per day were all predictive of osteoporosis. However, age at menar-che and menopause, years since menopause, and number of pregnancies and live births were irrelevant in this study. The logistic regression analysis and item reduction yielded a final tool (BFH-OST) based on age, body weight, height, and history of fracture after the age of 45 years. The BFH-OST index (cutoff =9.1), which performed better than OSTA, had a sensitivity of 73.6% and a specificity of 72.7% for identifying osteoporosis, with an area under the receiver operating characteristic curve of 0.797. Conclusion: BFH-OST may be a powerful and cost-effective new clinical risk assessment tool for prescreening postmenopausal women at increased risk for osteoporosis by DXA, especially for Han Chinese women.

[1]  Chung-Yuan Hsu,et al.  Development and Validation of an Osteoporosis Self-Assessment Tool for Taiwan (OSTAi) Postmenopausal Women-A Sub-Study of the Taiwan OsteoPorosis Survey (TOPS) , 2015, PloS one.

[2]  Yu Hu,et al.  Diagnostic value of Osteoporosis Self-Assessment Tool for Asians (OSTA) and quantitative bone ultrasound (QUS) in detecting high-risk populations for osteoporosis among elderly Chinese men , 2015, Journal of Bone and Mineral Metabolism.

[3]  E. M. Lewiecki,et al.  Clinician’s Guide to Prevention and Treatment of Osteoporosis , 2014, Osteoporosis International.

[4]  J. Kling,et al.  Osteoporosis prevention, screening, and treatment: a review. , 2014, Journal of women's health.

[5]  D. Alley,et al.  Body mass index is positively associated with bone mineral density in US older adults , 2014, Archives of Osteoporosis.

[6]  Noriko Yoshimura,et al.  A Meta‐Analysis of the Association of Fracture Risk and Body Mass Index in Women , 2014, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[7]  Hai Tang,et al.  Validation of an osteoporosis self-assessment tool to identify primary osteoporosis and new osteoporotic vertebral fractures in postmenopausal Chinese women in Beijing , 2013, BMC Musculoskeletal Disorders.

[8]  S. Sen,et al.  Calcium and vitamin D intake by postmenopausal women with osteoporosis in Spain: an observational calcium and vitamin D intake (CaVIT) study , 2013, Clinical interventions in aging.

[9]  S. Moon,et al.  Development and validation of osteoporosis risk-assessment model for Korean postmenopausal women , 2013, Journal of Bone and Mineral Metabolism.

[10]  B. Abrahamsen Screening: FRAX® in clinical practice , 2011, Nature Reviews Rheumatology.

[11]  Jay J Cao Effects of obesity on bone metabolism , 2011, Journal of orthopaedic surgery and research.

[12]  A. Hrõbjartsson,et al.  The Osteoporosis Self-Assessment Tool versus alternative tests for selecting postmenopausal women for bone mineral density assessment: a comparative systematic review of accuracy , 2009, Osteoporosis International.

[13]  A. Haberal,et al.  Identification of the risk factors for osteoporosis among postmenopausal women. , 2008, Maturitas.

[14]  J. Hilden,et al.  Performance of the Osteoporosis Self-Assessment Tool in ruling out low bone mineral density in postmenopausal women: a systematic review , 2007, Osteoporosis International.

[15]  J. Li-Yu,et al.  Validation of OSTA among Filipinos , 2005, Osteoporosis International.

[16]  P. Vestergaard,et al.  Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark , 2005, Osteoporosis International.

[17]  R. Stafford,et al.  National trends in osteoporosis visits and osteoporosis treatment, 1988-2003. , 2004, Archives of internal medicine.

[18]  David B. Holiday,et al.  Evaluation of decision rules for identifying low bone density in postmenopausal African-American women. , 2004, Journal of the National Medical Association.

[19]  J. Reginster,et al.  Korean experience with the OSTA risk index for osteoporosis: a validation study. , 2003, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[20]  Sheila M. Williams,et al.  Bone mineral density and body composition in boys with distal forearm fractures: a dual-energy x-ray absorptiometry study. , 2001, The Journal of pediatrics.

[21]  M. Hochberg Preventing Fractures in Postmenopausal Women with Osteoporosis , 2000, Drugs & aging.

[22]  H. Weiler,et al.  Percent body fat and bone mass in healthy Canadian females 10 to 19 years of age. , 2000, Bone.

[23]  E. Siris Alendronate in the treatment of osteoporosis: a review of the clinical trials. , 2000, Journal of women's health & gender-based medicine.

[24]  M. Greiner,et al.  Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. , 2000, Preventive veterinary medicine.

[25]  J. Tu,et al.  Development and validation of the Osteoporosis Risk Assessment Instrument to facilitate selection of women for bone densitometry. , 2000, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[26]  C. Longcope,et al.  Predictors of bone mass in perimenopausal women. A prospective study of clinical data using photon absorptiometry , 1990, Annals of internal medicine.

[27]  J A Swets,et al.  Measuring the accuracy of diagnostic systems. , 1988, Science.

[28]  K. Tsai,et al.  A Simple Tool to Identify Asian Women at Increased Risk of Osteoporosis , 2001, Osteoporosis International.

[29]  R. Stine,et al.  Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. , 1998, The American journal of managed care.

[30]  Claus Christiansen,et al.  Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. , 1994, World Health Organization technical report series.