Risk assessment instruments for screening bone mineral density in a Mediterranean population

Predicting Lumbar Vertebral Osteopenia Using LvOPI Scores and Logistic Regression Models in an Exploratory Study of Premenopausal Taiwanese Women

Purpose

To propose hybrid predicting models integrating clinical and magnetic resonance imaging (MRI) features to diagnose lumbar vertebral osteopenia (LvOPI) in premenopausal women.

Methods

This prospective study enrolled 101 Taiwanese women, including 53 before and 48 women after menopause. Clinical information, including age, body height, body weight and body mass index (BMI), were recorded. Bone mineral density (BMD) was measured by the dual-energy X-ray absorptiometry. Lumbar vertebral fat fraction (LvFF) was measured by MRI. LvOPI scores (LvOPISs) comprising different clinical features and LvFF were constructed to diagnose LvOPI. Statistical analyses included normality tests, linear regression analyses, logistic regression analyses, group comparisons, and diagnostic performance. A P value less than 0.05 was considered as statistically significant.

Results

The post-menopausal women had higher age, body weight, BMI, LvFF and lower BMD than the pre-menopausal women (all P < 0.05). The lumbar vertebral osteoporosis group had significantly higher age, longer MMI, and higher LvFF than the LvOPI group (all P < 0.05) and normal group (all P < 0.005). LvOPISs (AUC, 0.843 to 0.864) outperformed body weight (0.747; P = 0.0566), BMI (0.737; P < 0.05), age (0.649; P < 0.05), and body height (0.5; P < 0.05) in diagnosing LvOPI in the premenopausal women. Hybrid predicting models using logistic regression analysis (0.894 to 0.9) further outperformed all single predictors in diagnosing LvOPI in the premenopausal women (P < 0.05).

Conclusion

The diagnostic accuracy of the LvOPI can be improved by using our proposed hybrid predicting models in Taiwanese premenopausal women.

Modified SCORE tool for prediction of bone mineral density in Egyptian elderly women. Comparison of seven osteoporosis screening tools

We aimed to compare the performance of seven risk screening tools for detecting elderly Egyptian women with osteoporosis and to modify the tool with the best performance to increase the efficiency of referral for bone mineral density (BMD) testing. There are few studies about the epidemiology of osteoporosis in Egypt, in addition, there was no study done before to evaluate the performance of these seven screening tools in a large sample size. This aims to help clinicians restrict the use of DXA scan for those patients defined as "high risk" for osteoporosis which can substantially reduce the cost for the community and the patients, especially in developing countries. We conducted a cross-sectional study on 681 elderly women for measurement of BMD using DXA scans. The performance of the Simple Calculated Osteoporosis Risk Estimation (SCORE) was superior to other indices with the highest sensitivity and specificity. The newly modified SCORE tool at cutoff point ≥1 is a simple easy tool and shows good sensitivity (up to 94%) and acceptable specificity (up to 46.7%) in detecting osteoporosis in elderly women with fewer items and easier calculation.