Optimal Analysis to Discriminate Males’ Osteoporosis With Simple Physiological Indicators

Comparing self-assessment, functional, and anthropometric techniques in predicting osteoporosis

The osteoporosis self-assessment tool was more accurate than hand grip strength, gait speed, and calf circumference in predicting osteoporosis in women. Hand grip strength was more accurate than the osteoporosis self-assessment tool, gait speed, and calf circumference in predicting osteoporosis in men.

PURPOSE

The osteoporosis self-assessment tool, functional assessment, and anthropometric measurement are different techniques to identify those at risk of osteoporosis. This study aimed to compare the performance of these techniques in predicting osteoporosis.

METHODS

In this cross-sectional, hospital-based study including 1109 participants, the bone mineral density of the spine and hips was evaluated using the dual-energy X-ray absorptiometry. The Osteoporosis Self-Assessment Tool was used as a simple clinical risk assessment tool to screen for osteoporosis. Gait speed and hand grip strength were used as functional assessments to predict osteoporosis. Calf circumference was used as an anthropometric measurement to predict osteoporosis risk.

RESULTS

In women, the Osteoporosis Self-Assessment Tool was better than hand grip strength, gait speed, and calf circumference in predicting osteoporosis. In contrast, in men, hand grip strength was better than the Osteoporosis Self-Assessment Tool, gait speed, and calf circumference.

CONCLUSION

The application of simple, cost-effective techniques for the identification of osteoporosis risk will be beneficial for both screening and patient care when dual-energy X-ray absorptiometry is not available. We suggest that the Osteoporosis Self-Assessment Tool can be used to identify the risk of osteoporosis in women and hand grip strength measurement can be used for men.

The performance of osteoporosis self-assessment tool for Asians (OSTA) in identifying the risk of osteoporosis among Malaysian population aged 40 years and above

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.

Performance of Osteoporosis Self-Assessment Tool (OST) in Predicting Osteoporosis-A Review

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.