1
|
Uemura K, Takashima K, Higuchi R, Kono S, Mae H, Iwasa M, Abe H, Maeda Y, Kyo T, Imagama T, Ando W, Sakai T, Okada S, Hamada H. Assessing the utility of osteoporosis self-assessment tool for Asians in patients undergoing hip surgery. Osteoporos Sarcopenia 2024; 10:16-21. [PMID: 38690542 PMCID: PMC11056419 DOI: 10.1016/j.afos.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/25/2023] [Accepted: 01/18/2024] [Indexed: 05/02/2024] Open
Abstract
Objectives Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery. Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis. Methods A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index. Results DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of -5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis. Conclusions OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. Our findings may help identify high-risk patients who require further investigation using DXA.
Collapse
Affiliation(s)
- Keisuke Uemura
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Kazuma Takashima
- Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Ryo Higuchi
- Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Sotaro Kono
- Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Hirokazu Mae
- Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Makoto Iwasa
- Department of Orthopaedics, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuou-ku, Osaka, Osaka, Japan
| | - Hirohito Abe
- Department of Orthopaedics, Japan Community Health Care Organization Hoshigaoka Medical Center, 4-8-1, Hoshigaoka, Hirakata, Osaka, Japan
| | - Yuki Maeda
- Department of Orthopaedics, Kansai Medical Hospital, 1-1-7-2, Shinsenri-nishi, Toyonaka, Osaka, Japan
| | - Takayuki Kyo
- Department of Orthopaedics, Bell Land General Hospital, 500-3, Higashiyama, Naka-ku, Saka, Osaka, Japan
| | - Takashi Imagama
- Department of Orthopaedics, Yamaguchi University Graduate School of Medicine, 1-1-1, Minami-kogushi, Ube, Yamaguchi, Japan
| | - Wataru Ando
- Department of Orthopaedics, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo, Japan
| | - Takashi Sakai
- Department of Orthopaedics, Yamaguchi University Graduate School of Medicine, 1-1-1, Minami-kogushi, Ube, Yamaguchi, Japan
| | - Seiji Okada
- Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| |
Collapse
|
2
|
Miura K, Tanaka SM, Chotipanich C, Chobpenthai T, Jantarato A, Khantachawana A. Osteoporosis Prediction Using Machine-Learned Optical Bone Densitometry Data. Ann Biomed Eng 2024; 52:396-405. [PMID: 37882922 PMCID: PMC10808164 DOI: 10.1007/s10439-023-03387-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
Optical bone densitometry (OBD) has been developed for the early detection of osteoporosis. In recent years, machine learning (ML) techniques have been actively implemented for the areas of medical diagnosis and screening with the goal of improving diagnostic accuracy. The purpose of this study was to verify the feasibility of using the combination of OBD and ML techniques as a screening tool for osteoporosis. Dual energy X-ray absorptiometry (DXA) and OBD measurements were performed on 203 Thai subjects. From the OBD measurements and readily available demographic data, machine learning techniques were used to predict the T-score measured by the DXA. The T-score predicted using the Ridge regressor had a correlation of r = 0.512 with respect to the reference value. The predicted T-score also showed an AUC of 0.853 for discriminating individuals with osteoporosis. The results obtained suggest that the developed model is reliable enough to be used for screening for osteoporosis.
Collapse
Affiliation(s)
- Kaname Miura
- Biological Engineering Program, King Mongkut's University of Technology Thonburi, Bangkok, 10140, Thailand
- Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Shigeo M Tanaka
- Institute of Science and Engineering, Kanazawa University, Kanazawa, 920-1192, Japan
| | - Chanisa Chotipanich
- National Cyclotron and PET Center, Chulabhorn Hospital, Bangkok, 10140, Thailand
| | - Thanapon Chobpenthai
- Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, 10140, Thailand
| | - Attapon Jantarato
- National Cyclotron and PET Center, Chulabhorn Hospital, Bangkok, 10140, Thailand
| | - Anak Khantachawana
- Department of Mechanical Engineering, King Mongkut's University of Technology Thonburi, Bangkok, 10140, Thailand.
| |
Collapse
|
3
|
Zhao H, Zhu L, Fan L, Yang J, Hou J, Zhang G, Wang C, Pan J. Association of nocturnal sleep duration and sleep midpoint with osteoporosis risk in rural adults: a large-scale cross-sectional study. Sleep Breath 2023; 27:2191-2198. [PMID: 37009967 DOI: 10.1007/s11325-023-02818-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 03/11/2023] [Accepted: 03/20/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Evidence has suggested the linkage between sleep habits and several metabolic diseases, but the association of sleep factors with bone health remains unclear, especially in regions with low economic levels. Thus, this study aimed to investigate the relationship of nocturnal sleep duration and sleep midpoint with the osteoporosis risk in a rural population. METHOD Eligible subjects were derived from the Henan Rural Cohort Study. The Pittsburgh Sleep Quality Index was applied to collect sleep information including sleep initiating time and wake-up time. The bone mineral density of the calcaneus was measured by the ultrasonic bone density apparatus. Multivariable logistic regression models and restricted cubic splines were utilized to evaluate the odds ratio (OR) and 95% confidence intervals (95% CI). RESULTS For 8033 participants, 1636 subjects suffered from osteoporosis. Compared with the reference group (7 ~ h group), the ORs and 95% CI of osteoporosis associated with duration of nocturnal sleep were 1.32 (1.10, 1.56), 1.59 (1.25, 2.01), and 1.82 (1.25, 2.65) in the 8 ~ h, 9 ~ h, and ≥ 10 h group, respectively. Additionally, the adjusted ORs and 95% CI were 1.20 (1.01, 1.44) in the early sleep midpoint group and 1.09 (0.92, 1.29) in the intermediate sleep midpoint, compared with the late. Furthermore, there was a joint effect of long duration of nocturnal sleep and the early sleep midpoint on osteoporosis. CONCLUSION Long duration of nocturnal sleep and early sleep midpoint were independently and jointly associated with higher risk of osteoporosis in rural areas. TRIAL REGISTRATION The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.
Collapse
Affiliation(s)
- Hongfei Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Linghui Zhu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Lin Fan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Jing Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Gongyuan Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| | - Jun Pan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
| |
Collapse
|
4
|
Alshahrani F, Alsulaiman YA, Almashari YM, Alawad NK, Almousa SA, Allarakia Y, Aljaafri BA. Use of the Osteoporosis Self-Assessment Tool as a Screening Tool for Osteoporosis in Saudi Postmenopausal Women. Cureus 2023; 15:e37755. [PMID: 37213999 PMCID: PMC10193514 DOI: 10.7759/cureus.37755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Osteoporosis is commonly referred to as the "silent disease," as bone loss is gradual and asymptomatic. In older women and men, osteoporosis can lead to increased bone fragility, thus increasing the risk of fractures. These fractures are associated with healthcare costs, physical disabilities, impaired quality of life, and mortality. Therefore, the study's main objective was to assess the applicability of the osteoporosis self-assessment tool (OST) in predicting osteoporosis in Saudi postmenopausal women who are 60 years of age and older and to give a thorough understanding of how such a method can aid in the early diagnosis of osteoporosis in Saudi Arabia and give physicians enough time to treat it. Methods: This study was done at King Abdulaziz Medical City, Riyadh, Saudi Arabia, where we included postmenopausal Saudi women 60 years of age and older who took the bone mineral density (BMD) test in the family medicine department. The approximate target population in this group, between the years 2016 and 2022, was 2969 patients. All data was taken from the BestCare database at King Abdulaziz Medical City in Riyadh. Data were typed in an Excel sheet (Redmond, USA), then transferred to the R Studio software. The data collection method was chart review, so no informed consent was needed from patients. Names and medical record numbers were not stored. Results: The study included 2969 participants. According to the bone mineral density (BMD) T score results, 490 participants (16.5%) were normal, 1746 participants (58.8%) had osteopenia, and 733 participants (24.7%) suffered from osteoporosis. BMD T scores for normal, osteopenia, and osteoporosis participants were -0.6 (-0.9, -.3), -1.8 (-2.1), and -3 (-3.5, -2.7), consecutively. Estimated OSTI scores for those patients were 2 (0, 4), 1 (-2, 3), and -1 (-4, 1), consecutively. According to the OSTI score for normal participants, 4.29% were classified as being at high risk of osteoporosis. A high risk of osteoporosis was identified in 0.74% of those with osteopenia. 27.83% of osteoporosis patients were classified as being at high risk of osteoporosis. To differentiate normal individuals from those with osteopenia, the cutoff value with optimal sensitivity was 3.5. At such a cutoff value, the test sensitivity was 81.04%. To differentiate normal participants from those with osteoporosis, the cutoff value with optimal sensitivity was 2.5. At such a cutoff value, the test sensitivity was 86.49%. To differentiate osteopenia from osteoporosis patients, the cutoff threshold with optimal sensitivity was 1.5. At such a threshold, sensitivity was 78.44%. Conclusion: OSTA is a simple and validated tool that can identify subjects at increased risk of osteoporosis. Its use could facilitate a more cost-effective use of BMD; by avoiding measurements in low-risk groups.
Collapse
Affiliation(s)
- Fahad Alshahrani
- Family Medicine, King Abdulaziz Medical City Riyadh-Ministry of the National Guard Health Affairs, Riyadh, SAU
- Collage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Family Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Yazeed A Alsulaiman
- Family Medicine, King Abdulaziz Medical City Riyadh-Ministry of the National Guard Health Affairs, Riyadh, SAU
- Family Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Yasser M Almashari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Nawaf K Alawad
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Saad A Almousa
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Yazeed Allarakia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Bader A Aljaafri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| |
Collapse
|
5
|
Zhang J, Zhou R, Luo X, Dai Z, Qu G, Li J, Wu P, Yuan X, Li J, Jiang W, Zhang Z. Routine chest CT combined with the osteoporosis self-assessment tool for Asians (OSTA): a screening tool for patients with osteoporosis. Skeletal Radiol 2022; 52:1169-1178. [PMID: 36520217 DOI: 10.1007/s00256-022-04255-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The osteoporosis self-assessment tool for Asians (OSTA) is a common screening tool for osteoporosis. The seventh thoracic CT (CT-T7) Hounsfield unit (HU) measured by chest CT correlates with osteoporosis. This study aimed to investigate the diagnostic value of OSTA alone, CT-T7 alone, or the combination of OSTA and CT-T7 in osteoporosis. MATERIALS AND METHODS In this study, 1268 participants were grouped into 586 men and 682 women. We established multiple linear regression models by combining CT-T7 and OSTA. Receiver operating characteristic (ROC) curves were used to evaluate the ability to diagnose osteoporosis. RESULTS In the male group, the mean age was 59.02 years, and 108 patients (18.4%) had osteoporosis. In the female group, the mean age was 63.23 years, and 308 patients (45.2%) had osteoporosis. By ROC curve comparison, the CT-T7 (male, AUC = 0.789, 95% CI 0.745-0.832; female, AUC = 0.835, 95% CI 0.805-0.864) in the diagnosis of osteoporosis was greater than the OSTA (male, AUC = 0.673, 95% CI 0.620-0.726; female, AUC = 0.775, 95% CI 0.741-0.810) in both the male and female groups (p < 0.001). When OSTA was combined with CT, the equation of multiple linear regression (MLR) was obtained as follows: female = 3.020-0.028*OSTA-0.004*CT-T7. In the female group, it was found that the AUC of MLR (AUC = 0.853, 95% CI 0.825-0.880) in the diagnosis of osteoporosis was larger than that of CT-T7 (p < 0.01). When the MLR was 2.65, the sensitivity and specificity were 53.9% and 90%, respectively. CONCLUSION For a patient who has completed chest CT, CT-T7 (HU) combined with OSTA is recommended to identify the high-risk population of osteoporosis, and it has a higher diagnostic value than OSTA alone or CT-T7 alone, especially among females. For a female with MLR greater than 2.65, further DXA examination is needed.
Collapse
Affiliation(s)
- Jiongfeng Zhang
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Ruiling Zhou
- Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Xiaohui Luo
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Zhengzai Dai
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Gaoyang Qu
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Juncheng Li
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Pengyun Wu
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Xuhui Yuan
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jiayu Li
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Wei Jiang
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.,Medical Department of Graduate School, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Zhiping Zhang
- Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.
| |
Collapse
|
6
|
Bui MH, Dao PT, Khuong QL, Le PA, Nguyen TTT, Hoang GD, Le TH, Pham HT, Hoang HXT, Le QC, Dao XT. Evaluation of community-based screening tools for the early screening of osteoporosis in postmenopausal Vietnamese women. PLoS One 2022; 17:e0266452. [PMID: 35381025 PMCID: PMC8982873 DOI: 10.1371/journal.pone.0266452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background Osteoporosis affects people worldwide. However, there are few validated tools for the early screening of osteoporosis in Vietnam. We set out to evaluate the performance of the osteoporosis self-assessment tool for Asians (OSTA) and the osteoporosis screening tool for Chinese (OSTC) for the early screening of osteoporosis in postmenopausal Vietnamese women. Methods We analyzed retrospective data from 797 postmenopausal Vietnamese women. The bone mineral density (BMD) in the lumbar vertebrae (L1–L4) and the left and right femoral necks of all participants were measured using dual-energy X-ray absorptiometry (DXA). Osteoporosis was defined as the BMD (T-score) < -2.5. The OSTA and OSTC scores were calculated from the age and weight of participants. Receiver operating characteristic analysis was conducted to compare the performance of the two tools with the BMD measurements by DXA at different anatomical sites. Results The rates of osteoporosis determined by BMD varied between anatomical sites, and ranged from 43.4% to 54.7% in the lumbar vertebrae and 29.2% and 8.9% in the left and right femoral necks, respectively. For the vertebrae, the area under the curve (AUC) for OSTA ranged from 70.9% to 73.9% and for OSTC ranged from 68.7% to 71.6%. The predictive value of both tools was higher for femoral necks, with the AUC of OSTA for the left and right femoral necks being 80.0% and 85.8%, respectively. The corresponding figures for OSTC were 80.5% and 86.4%, respectively. The highest sensitivity and specificity of OSTA were 74.6% and 81.4%, while these figures for OSTC were 73.9% and 82.6%, respectively. Conclusion OSTA and OSTC were shown to be useful self-assessment tools for osteoporosis detection in Vietnam postmenopausal women. Further research is encouraged to determine the applicability of tools for other populations and settings.
Collapse
Affiliation(s)
- My Hanh Bui
- Hanoi Medical University, Hanoi, Vietnam
- Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Phuoc Thang Dao
- Interactive Research and Development, Ho Chi Minh City, Vietnam
| | | | | | | | | | - Tu Hoang Le
- Viet Duc Hospital, Hoan Kiem, Hanoi, Vietnam
| | - Hoai Thu Pham
- Hanoi Medical University, Hanoi, Vietnam
- Hanoi Medical University Hospital, Hanoi, Vietnam
| | | | | | - Xuan Thanh Dao
- Hanoi Medical University, Hanoi, Vietnam
- Hanoi Medical University Hospital, Hanoi, Vietnam
- * E-mail:
| |
Collapse
|
7
|
Ang SB, Xia JY, Cheng SJ, Chua MT, Goh L, Dhaliwal SS. A pilot screening study for low bone mass in Singaporean women using years since menopause and BMI. Climacteric 2021; 25:163-169. [PMID: 33928868 DOI: 10.1080/13697137.2021.1908989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Current risk assessment tools for osteoporosis have inconsistent performance across different cohorts, making them difficult for clinical practice. This study aimed to evaluate a simple screening index comprising years since menopause (YSM) and body mass index (BMI) that identifies postmenopausal Singaporean women with a greater likelihood of low bone mass. METHODS The study used data from 188 treatment-naïve postmenopausal women. The associations between low bone mass and different demographic variables, including age, YSM and BMI, were assessed using multivariable logistic regression. Diagnostic performance of the calculated screening index was compared to the Osteoporosis Self-Assessment Tool for Asians (OSTA) and the Fracture Risk Assessment Tool (FRAX®). RESULTS YSM and BMI were significantly associated with low bone mass. The area under the receiver operating characteristic curves was 0.803 for the screening index, 0.759 for the OSTA, 0.683 for the FRAX® (major osteoporotic fracture probability [MOFP]) and 0.647 for the FRAX® (hip fracture probability [HFP]). Non-parametric Spearman's correlation between the screening index and the other models was 0.857 with the OSTA score, 0.694 with the FRAX® (HFP) and 0.565 with the FRAX® (MOFP) (p < 0.0005). CONCLUSIONS The diagnostic performance of the screening index comprising YSM and BMI was equivalent to the OSTA and the FRAX®. A risk chart was developed for clinicians to identify and recommend subjects for a further dual-energy X-ray absorptiometry scan. Validation of this model in larger and more diverse cohorts is required.
Collapse
Affiliation(s)
- S B Ang
- Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.,Menopause Unit, KK Women's and Children's Hospital, Singapore, Singapore
| | - J Y Xia
- Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - S J Cheng
- Menopause Unit, KK Women's and Children's Hospital, Singapore, Singapore
| | - M T Chua
- Menopause Unit, KK Women's and Children's Hospital, Singapore, Singapore
| | - L Goh
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - S S Dhaliwal
- Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.,Menopause Unit, KK Women's and Children's Hospital, Singapore, Singapore.,Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.,Department of Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia, Australia
| |
Collapse
|
8
|
Tang K, Zhang Q, Peng N, Hu Y, Xu S, Zhang M, Wang R, Shi L. Brachial-ankle pulse wave velocity is associated with the risk of osteoporosis: a cross-sectional evidence from a Chinese community-based cohort. J Orthop Surg Res 2021; 16:3. [PMID: 33397452 PMCID: PMC7783987 DOI: 10.1186/s13018-020-02125-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/27/2020] [Indexed: 12/30/2022] Open
Abstract
Background Association of arterial stiffness and osteoporosis has been well documented in elderly population. However, it is not clear whether they co-progress from the early stages through common mechanisms. The object of this study was to evaluate possible associations between arterial stiffness and osteoporosis by measuring brachial-ankle pulse wave velocity (baPWV) and the Osteoporosis Self-Assessment Tool for Asia (OSTA) index among a healthy population of Chinese aged 40 years and older. Whether baPWV can be used as a predictor of osteoporosis on OSTA was further assessed. Methods This study was cross-sectional in design. Of 3984 adults aged 40 years and older in the Yunyan district of Guiyang (Guizhou, China) who underwent both OSTA and baPWV measurements within 1 month, 1407 were deemed eligible for inclusion (women, 1088; men, 319). Results The mean baPWV was 1475 ± 302 cm/s (range,766–3459 cm/s). baPWV in 110 individuals with high risk of osteoporosis (OSTA index < − 4) was higher than that of individuals with non-high risk (1733 ± 461 cm/s vs. 1447 ± 304 cm/s, P < 0.001). OSTA index was negatively correlated with baPWV(ρ = − 0.296, P < 0.001) after adjusting for age, sex, body mass index, waist circumference, diastolic blood pressure, and creatinine clearance rate. baPWV was an independent predictor for the presence of high risk of osteoporosis (β = − 0.001, P < 0.001) and was consistent across age and sex subgroups, and the optimal baPWV cutoff value for predicting the presence of high risk of osteoporosis and fracture was 1693 cm/s. The AUC was 0.722 (95% confidence interval [CI], 0.667–0.777; P < 0.001, sensitivity of 52.8% and specificity of 83.6%). Conclusions We conclude that arterial stiffness measured by baPWV is well correlated with the severity of osteoporosis evaluated by OSTA. baPWV index may be a valuable tool for identifying individuals with risk of developing osteoporosis. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-020-02125-3.
Collapse
Affiliation(s)
- Kun Tang
- Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.,Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Qiao Zhang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Nianchun Peng
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Ying Hu
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Shujing Xu
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Miao Zhang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Rui Wang
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China
| | - Lixin Shi
- Department of Endocrinology, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550000, China.
| |
Collapse
|
9
|
Gao C, Song H, Chen B, Zhang Z, Yue H. The Assessment of the Osteoporosis Self-Assessment Tool for Asians and Calcaneal Quantitative Ultrasound in Identifying Osteoporotic Fractures and Falls Among Chinese People. Front Endocrinol (Lausanne) 2021; 12:684334. [PMID: 34040589 PMCID: PMC8143027 DOI: 10.3389/fendo.2021.684334] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/20/2021] [Indexed: 01/22/2023] Open
Abstract
The lack of DXA has made the diagnosis and treatment of osteoporosis extremely difficult in the vast rural areas of China, which has the largest population with high risks of osteoporosis. The aims of this cross-sectional study were to evaluate the association between the osteoporosis self-assessment tool for Asians (OSTA) and calcaneus quantitative ultrasound (QUS) in populations residing in Shanghai, China, and their assessment in predicting osteoporotic fractures and falls. A population of 12,033 participants, including 1272 males (average age 68.3 ± 9.8 years, range 28-100 years) and 10,761 females (average 56.8 ± 11.4 years, range 23-99 years), was gathered. OSTA and calcaneus QUS (Sonost 2000, OsteoSys) values were measured. Spearman's correlation and Cohen's kappa were used to determine the association and agreement between the OSTA and QUS. Receiver operating characteristic (ROC) curves were adapted to assess the performance and optimal cutoff values for the OSTA and QUS in osteoporotic fracture and fall screening. In total, the prevalence of osteoporotic fractures (low-trauma fractures including fractures of the spine, hip, forearm, humerus and ribs) was 15.2% in women, and 17.7% reported a history of falls (falling from standing height more than once in the past year). The percentages of men with the same history were 8.4% and 11.7%, respectively. The association between the OSTA and QUS was found to be rs = 0.393, κ = 0.137, p < 0.001. The OSTA (cutoff < -1) revealed an area under ROC curve (AUC) of 0.590 in identifying female individuals with moderate or high risk of osteoporosis defined by QUS (T-score < -1). The QUS T-score lower than -1.55 or -1.40 in postmenopausal women may lead to an increased risk of falls or osteoporotic fractures, respectively. The agreement between QUS and the OSTA seemed to be limited in determining individuals at risk of osteoporosis. Measuring bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) may still be necessary in the clinical diagnosis of osteoporosis. OSTA and QUS T-scores less than the respective cutoff values may indicate an increased risk of osteoporotic fractures and falls that individual should be further treated and screened by DXA.
Collapse
Affiliation(s)
- Chao Gao
- Shanghai Clinical Research Center of Bone Diseases, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Huijiang Song
- Department of Internal Medicine, Caolu Community Health Service Center, Shanghai, China
| | - Bihua Chen
- Department of Internal Medicine, Longhua Community Health Service Center, Shanghai, China
| | - Zhenlin Zhang
- Shanghai Clinical Research Center of Bone Diseases, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Hua Yue
- Shanghai Clinical Research Center of Bone Diseases, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Hua Yue,
| |
Collapse
|
10
|
Subasinghe HWAS, Lekamwasam S, Ball P, Morrissey H, Waidyaratne E. Estimating regional bone mineral density-based T-scores using clinical information; tools validated for postmenopausal women in Sri Lanka. Osteoporos Sarcopenia 2020; 6:122-128. [PMID: 33102805 PMCID: PMC7573505 DOI: 10.1016/j.afos.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/23/2020] [Accepted: 08/29/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives This study aims to develop and validate a country specific osteoporosis risk assessing tool for Sri Lankan postmenopausal women. Methods Community-dwelling postmenopausal women were enrolled to development (n = 602) and validation (n = 339) samples. Clinical risk factors (CRFs) of osteoporosis were assessed. Bone mineral densities (BMD) of femoral neck, total hip and lumbar spine were assessed by dual energy X-ray absorptiometry (DXA) scan. Radial ultrasound (US) bone scan was done. Linear regression analysis was performed in development sample considering regional BMDs as dependent and CRFs as independent variables. Regression equations were developed to estimate regional BMDs using best predictive CRFs. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) were assessed to validate the new tools. Results Age, body weight and US T-scores showed positive correlations with BMDs of all 3 sites. Two osteoporosis risk assessing tools (OPRATs) were developed as OPRAT-1 and OPRAT-2. Prevalence of osteoporosis, in the validation sample was 74.3%. Sensitivity were high in both tools (OPRAT-1 and OPRAT-2; 83.2% and 82.5%) while specificity were moderate (44.8% for both). PPV of OPRAT-1 and OPRAT-2 were 79.5% and 81.2%. Both tools showed moderate NPV (OPRAT-1 and OPRAT-2; 51% and 47%). Conclusions Both OPRAT-1 and OPRAT-2 have high performance in screening postmenopausal women in Sri Lanka for risk of osteoporosis. OPRAT-2 is more convenient and can be used in any healthcare setting with limited resources to identify women who will be benefitted by DXA. OPRAT-1 can be used if the radial US facility is available.
Collapse
Affiliation(s)
| | | | - Patrick Ball
- School of Pharmacy, University of Wolverhampton, United Kingdom
| | - Hana Morrissey
- School of Pharmacy, University of Wolverhampton, United Kingdom
| | | |
Collapse
|
11
|
The performance of osteoporosis self-assessment tool for Asians (OSTA) in identifying the risk of osteoporosis among Malaysian population aged 40 years and above. Arch Osteoporos 2019; 14:117. [PMID: 31781876 DOI: 10.1007/s11657-019-0666-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/29/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The concordance between osteoporosis self-assessment tool for Asians (OSTA) and dual-energy X-ray absorptiometry (DXA) was fair in the study. Modification of OSTA cutoff values improved its sensitivity to identify subjects at risk for suboptimal bone health (osteopenia/osteoporosis) and osteoporosis. PURPOSE Osteoporosis self-assessment tool for Asians (OSTA) is a convenient screening algorithm used widely to identify patients at risk of osteoporosis. Currently, the number of studies validating OSTA in Malaysian population is limited. This study aimed to validate the performance of OSTA in identifying subjects with osteoporosis determined with DXA. METHODS This cross-sectional study recruited 786 Malaysians in Klang Valley, Malaysia. Their bone health status was assessed by DXA and OSTA. The association and agreement between OSTA and bone mineral density assessment by DXA were determined by Pearson's correlation and Cohen's kappa, respectively. Receiver operating characteristics (ROC) curves were used to determine the sensitivity, specificity, and area under the curve (AUC) for OSTA. RESULTS OSTA and DXA showed a fair association in the study (r = 0.382, κ = 0.159, p < 0.001). OSTA (cutoff < - 1) revealed a sensitivity of 32.3%, specificity of 92.3%, and AUC of 0.618 in identifying subjects with suboptimal bone health. The sensitivity of OSTA (cutoff < - 4) in determining subjects at risk of osteoporosis was better among women (sensitivity = 20%) than men (sensitivity = 0%). Modified OSTA cutoff values improved the sensitivity of OSTA in identifying subjects with suboptimal bone health (men = 81.0% at cutoff 3.4, women = 82.8% at cutoff 2.0) and osteoporosis (men = 81.8% at cutoff 1.8, women = 81.3% at cutoff 0.8). CONCLUSION OSTA with its original cutoff values is ineffective in identifying individuals at risk for osteoporosis. Adjusting the cutoff values significantly increases the sensitivity of OSTA, thus highlighting the need to validate this instrument among the local population before using it for osteoporosis screening clinically.
Collapse
|
12
|
Meng J, Sun N, Chen Y, Li Z, Cui X, Fan J, Cao H, Zheng W, Jin Q, Jiang L, Zhu W. Artificial neural network optimizes self-examination of osteoporosis risk in women. J Int Med Res 2019; 47:3088-3098. [PMID: 31179797 PMCID: PMC6683875 DOI: 10.1177/0300060519850648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective This study aimed to investigate the application of an artificial neural network (ANN) in optimizing the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods OSTA score was calculated for each female participant that underwent dual-energy X-ray absorptiometry examination in two hospitals (one in each of two Chinese cities, Harbin and Ningbo). An ANN model was built using age and weight as input and femoral neck T-score as output. Osteoporosis risk screening by joint application of ANN and OSTA score was evaluated by receiver operating characteristic curve analysis. Results Nearly 90% of women with dual-energy X-ray absorptiometry-determined femoral neck osteoporosis were ≥60 years old. The ANN with age and weight as input and OSTA score both identified osteoporosis, with respective accuracy rates of 78.8% and 78.3%. However, both methods failed to identify osteoporosis in women < 60 years old. Compared with OSTA score alone, combined use of the two tools increased the rate of osteoporosis recognition among women > 80 years old. Conclusions OSTA score-mediated osteoporosis risk screening should be restricted to women ≥60 years old. Joint application of ANN and OSTA improved osteoporosis risk screening among Chinese women > 80 years old.
Collapse
Affiliation(s)
- Jia Meng
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ning Sun
- 2 Office of Academic Research, Ningbo Health Career Technical College, Ningbo, China
| | - Yali Chen
- 3 Department of Spine Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | | | - Xiaomeng Cui
- 5 School of Measurement-Control Tech & Communications Engineering, Harbin University of Science and Technology, Harbin, China
| | - Jingxue Fan
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hailing Cao
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wangping Zheng
- 3 Department of Spine Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Qiying Jin
- 3 Department of Spine Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Lihong Jiang
- 1 Department of General Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wenliang Zhu
- 6 Department of Pharmacy, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| |
Collapse
|
13
|
Subramaniam S, Ima-Nirwana S, Chin KY. Performance of Osteoporosis Self-Assessment Tool (OST) in Predicting Osteoporosis-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1445. [PMID: 29987247 PMCID: PMC6068473 DOI: 10.3390/ijerph15071445] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/28/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022]
Abstract
Bone health screening plays a vital role in the early diagnosis and treatment of osteoporosis to prevent fragility fractures among the elderly and high-risk individuals. Dual-energy X-ray absorptiometry (DXA), which detects bone mineral density, is the gold standard in diagnosing osteoporosis but is not suitable for screening. Therefore, many screening tools have been developed to identify individuals at risk for osteoporosis and prioritize them for DXA scanning. The Osteoporosis Self-assessment Tool (OST) is among the first tools established to predict osteoporosis in postmenopausal women. It can identify the population at risk for osteoporosis, but its performance varies according to ethnicity, gender, and age. Thus, these factors should be considered to ensure the optimal use of OST worldwide. Overall, OST is a simple and economical screening tool to predict osteoporosis and it can help to optimize the use of DXA.
Collapse
Affiliation(s)
- Shaanthana Subramaniam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
| |
Collapse
|
14
|
Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111380. [PMID: 29137199 PMCID: PMC5708019 DOI: 10.3390/ijerph14111380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 02/07/2023]
Abstract
Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < -4, n = 1585), medium-risk (-1 ≥ OSTA ≥ -4, n = 1985), and low-risk (OSTA > -1, n = 3137) patients. Two-sided Pearson's, chi-squared, or Fisher's exact tests were used to compare categorical data. Unpaired Student's t-test and Mann-Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed with injury mechanisms as adjusted variables to evaluate the effects of OSTA-related grouping on the fracture patterns. Results: High- and medium-risk patients were significantly older, had higher incidences of comorbidity, and were more frequently injured from a fall and bicycle accident than low-risk patients did. Compared to low-risk patients, high- and medium-risk patients had a higher injury severity and mortality. In the propensity-score matched population, the incidence of fractures was only different in the extremity regions between high- and low-risk patients as well as between medium- and low-risk patients. The incidences of femoral fractures were significantly higher in high-risk (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.73-4.24; p < 0.001) and medium-risk patients (OR, 1.4; 95% CI, 1.24-1.54; p < 0.001) than in low-risk patients. In addition, high-risk patients had significantly lower odds of humeral, radial, patellar, and tibial fractures; however, such lower odds were not found in medium- risk than low-risk patients. Conclusions: The fracture patterns of female trauma patients with high- and medium-risk osteoporosis were different from that of low-risk patients exclusively in the extremity region.
Collapse
|
15
|
Chin KY, Low NY, Kamaruddin AAA, Dewiputri WI, Soelaiman IN. Agreement between calcaneal quantitative ultrasound and osteoporosis self-assessment tool for Asians in identifying individuals at risk of osteoporosis. Ther Clin Risk Manag 2017; 13:1333-1341. [PMID: 29070951 PMCID: PMC5640400 DOI: 10.2147/tcrm.s145519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Calcaneal quantitative ultrasound (QUS) is a useful tool in osteoporosis screening. However, QUS device may not be available at all primary health care settings. Osteoporosis self-assessment tool for Asians (OSTA) is a simple algorithm for osteoporosis screening that does not require any sophisticated instruments. This study explored the possibility of replacing QUS with OSTA by determining their agreement in identifying individuals at risk of osteoporosis. Methods A cross-sectional study was conducted to recruit Malaysian men and women aged ≥50 years. Their bone health status was measured using a calcaneal QUS device and OSTA. The association between OSTA and QUS was determined using Spearman’s correlation and their agreement was assessed using Cohen Kappa and receiver-operating curve. Results All QUS indices correlated significantly with OSTA (p<0.05). The agreement between QUS and OSTA was minimal but statistically significant (p<0.05). The performance of OSTA in identifying subjects at risk of osteoporosis according to QUS was poor-to-fair in women (p<0.05), but not statistically significant for men (p>0.05). Changing the cut-off values improved the performance of OSTA in women but not in men. Conclusion The agreement between QUS and OSTA is minimal in categorizing individuals at risk of osteoporosis. Therefore, they cannot be used interchangeably in osteoporosis screening.
Collapse
Affiliation(s)
- Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Nie Yen Low
- ASASIpintar Foundation Program, PERMATApintar National Gifted Centre, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Alia Annessa Ain Kamaruddin
- ASASIpintar Foundation Program, PERMATApintar National Gifted Centre, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Wan Ilma Dewiputri
- ASASIpintar Foundation Program, PERMATApintar National Gifted Centre, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Ima-Nirwana Soelaiman
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| |
Collapse
|
16
|
Chin KY. A review on the performance of osteoporosis self-assessment tool for Asians in determining osteoporosis and fracture risk. Postgrad Med 2017; 129:734-746. [PMID: 28695762 DOI: 10.1080/00325481.2017.1353394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The prevalence of osteoporosis in Asian countries is growing. An effective screening method will enable patients at risk for osteoporosis to receive early diagnosis and treatment, and avoid overcrowding the limited dual-energy x-ray absorptiometry (DXA) machines available in Asian countries. Many simple osteoporosis screening algorithms have been developed but they are not validated for use in Asian populations. osteoporosis self-assessment tools for Asians (OSTA), established using a multinational Asian cohort, is the first screening algorithm that caters for the Asian populations. It considers only body weight and age in the algorithm. It shows consistently high performance and sensitivity in identifying postmenopausal women at risk for osteoporosis in many Asian countries. Its usage has been expanded for identifying osteoporosis in men, as well as determining fracture risk for both sexes. However, the performance of OSTA is influenced by age, sex, ethnicity and site of BMD measurement to define osteoporosis. Its usage is also limited in individuals without apparent risk factors. These limitations should be noted by physicians considering the use of OSTA in clinical setting. As a conclusion, OSTA is a cost-effective measure for osteoporosis screening in primary healthcare setting.
Collapse
Affiliation(s)
- Kok-Yong Chin
- a Department of Pharmacology , Universiti Kebangsaan Malaysia Medical Centre , Cheras , Malaysia
| |
Collapse
|