Diagnostic Value of Clinical Parameters for the Prediction of Osteoporosis in Menopause Iranian Women

Abstract

Background: Osteoporosis might result in an increased risk of bone fracture. Diagnosis of osteoporosis results in proper treatment and reduction of fracture rate. Objectives: This study aimed to construct a predictive model of osteoporosis case finding in Iranian women. Methods: A prospective diagnostic value study was designed, enrolling 317 asymptomatic women 50 years old or more referred for screening, at the Imam Hossein Medical Center, Tehran, Iran, for two years. The data was collected with the census method. A questionnaire including risk factors was completed, and bone mass densitometry (BMD) was done by the dual-energy X-ray absorptiometry (DXA) method in all cases. According to standard curves, bone density of the femur and lumbar spine clarified osteoporosis status for each person. In the first step, univariate analysis with osteoporosis as the main outcome did use the chi-squared test, independent sample t-test. In the next step, factors with a P-value of less than 0.2 were included in the multivariate logistic model, and a predictive model was constructed. The goodness of fit test was applied to assess the model building. The area under the curve (AUC) calculated for the model and the best cut-point for risk of menopause according to the Youden index were determined. The significance level was set at 0.05 for statistical analysis. Statistical analyses did use the program SSPS version 17.0 (SPSS, Inc., Chicago, IL, USA). Results: In 317 cases of the present study, the mean age of the population was 52.46 years old. Ninety-nine (%31.2) of these asymptomatic women revealed osteoporosis on the BMD test. Age and family history of osteoporosis were risk factors, and BMI, parity, and menopause age were protective factors for osteoporosis. Constructed model of osteoporosis prediction was as follows: (age × 0.149) + (family history × 0.963) - (BMI × 0.088) - (menopause age × 0.097) - (parity × 0.80). Optimal cutoff = 0.336 based on Youden method was chosen to predict the risk of osteoporosis. Conclusions: BMD test in Iran in more than 50 years old might find positive osteoporotic cases in at least 23.8%. BMD test in Iran in more than 50 years old might find positive osteoporotic cases in at least 23.8%. A model of osteoporosis probability constructed based on age, family history, menopause age, and parity in the present study can predict women at risk of osteoporosis.