Abstract
BackgroundThis study aimed to validate the effectiveness of the Osteoporosis Self-assessment Tool for Asians (OSTA) in identifying postmenopausal women at increased risk of primary osteoporosis and painful new osteoporotic vertebral fractures in a large selected Han Chinese population in Beijing.MethodsWe assessed the performance of the OSTA in 1201 women. Subjects with an OSTA index > -1 were classified as the low risk group, and those with an index ≤ -1 were classified as the increased risk group. Osteoporosis is defined by a T-score ≤ 2.5 standard deviations according to the WHO criteria. All painful, new vertebral fractures were identified by X-ray and MRI scans with correlating clinical signs and symptoms. We determined the sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve for correctly selecting women with osteoporosis and painful new vertebral fractures.ResultsOf the study subjects, 29.3% had osteoporosis, and the prevalence of osteoporosis increased progressively with age. The areas under the ROC curves of the OSTA index (cutoff = -1) to identify osteoporosis in the femoral neck, total hip, and lumbar spine were 0.824, 0.824, and 0.776, respectively. The sensitivity and specificity of the OSTA index (cutoff = -1) to identify osteoporosis in healthy women were 66% and 76%, respectively. With regard to painful new vertebral fractures, the area under the ROC curve relating the OSTA index (cutoff = -1) to new vertebral fractures was 0.812.ConclusionsThe OSTA may be a simple and effective tool for identifying the risk of osteoporosis and new painful osteoporotic vertebral fractures in Han Chinese women.
Highlights
This study aimed to validate the effectiveness of the Osteoporosis Self-assessment Tool for Asians (OSTA) in identifying postmenopausal women at increased risk of primary osteoporosis and painful new osteoporotic vertebral fractures in a large selected Han Chinese population in Beijing
A sample of 1320 postmenopausal women in Beijing participated in this study
The assessed subjects included 173 women who had suffered a painful vertebral fracture within 6 months before the bone mineral density (BMD) measurement and 1028 healthy subjects attending for routine screening without specific osteoporosis-associated symptoms
Summary
This study aimed to validate the effectiveness of the Osteoporosis Self-assessment Tool for Asians (OSTA) in identifying postmenopausal women at increased risk of primary osteoporosis and painful new osteoporotic vertebral fractures in a large selected Han Chinese population in Beijing. Osteoporosis, which leads to fragility fractures, represents a major public health problem in Asian countries, especially China, which is the largest and most populous developing country in the world. Measurement of bone mineral density (BMD) using dual X-ray absorptiometry (DXA) is widely accepted as the gold standard of osteoporosis diagnosis, and it is a primary predictor of fragility fractures. DXA is not widely available in most developing countries including China because the DXA and BMD measurement equipment are expensive. An ideal simple screening tool to identify the elderly population at risk for osteoporosis would not require DXA measurements
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