Zha Xiao-Yun, Hu Yu, Pang Xiao-Na, Chang Gui-Lin, Li Li
Department of Geriatrics, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
J Bone Miner Metab. 2015 Mar;33(2):230-8. doi: 10.1007/s00774-014-0587-5. Epub 2014 Apr 20.
This study aims to evaluate an osteoporosis self-assessment tool for Asians (OSTA) and quantitative bone ultrasound (QUS) and their combination in detecting populations at high risk for osteoporosis, and to determine the best cutoff value for the diagnosis of osteoporosis among elderly Chinese men. A group of Chinese men, aged ≥ 60 years, recruited from the health checkup population of Zhongshan Hospital, Fudan University, were included. The OSTA index was calculated from age and weight. Bone mineral density (BMD) at left hip (femoral neck, internal, and total hip) and lumbar spine (L1-L4, L-Total) was measured with dual-energy X-ray absorptiometry (DXA), and calcaneal BMD was measured with QUS. Receiver operating characteristic analysis was used to determine the best cutoff values, sensitivity, and specificity. The area under the curve (AUC) between the different screening tools was compared. Our study included 472 men with mean age of 78.0 years. The prevalence of osteoporosis was 27.7%.The best cutoff for OSTA was -3.5 for predicting men with osteoporosis at any site; this yielded a sensitivity and specificity of 47.3% and 76.8%, respectively. The AUC for OSTA was 0.676. The optimal cutoff for QUS-T score was -1.25, with a sensitivity of 80.4% and specificity of 59.7%. The AUC for QUS-T score was 0.762. Combining QUS with OSTA improved the specificity to 92.9% but reduced sensitivity to 36.1%. A new variable derived from a combination of OSTA and the QUS-T score gave a better performance, with sensitivity of 70.1% and specificity of 72.1%; the AUC for this variable was 0.771, which was greater than OSTA but not different from QUS alone. In conclusion, OSTA and QUS, respectively, and their combination may help find populations at high risk for osteoporosis, which could be an alternative method for diagnosing osteoporosis, especially in areas where DXA measurement is not accessible.
本研究旨在评估亚洲人骨质疏松自我评估工具（OSTA）和定量骨超声（QUS）及其联合应用在检测骨质疏松高危人群中的作用，并确定中国老年男性骨质疏松诊断的最佳截断值。纳入了一组年龄≥60岁、从复旦大学附属中山医院健康体检人群中招募的中国男性。根据年龄和体重计算OSTA指数。采用双能X线吸收法（DXA）测量左髋部（股骨颈、大转子和全髋）及腰椎（L1-L4、L-全）的骨密度（BMD），并采用QUS测量跟骨BMD。采用受试者工作特征分析来确定最佳截断值、敏感性和特异性。比较不同筛查工具之间的曲线下面积（AUC）。我们的研究纳入了472名平均年龄为78.0岁的男性。骨质疏松患病率为27.7%。OSTA预测任何部位骨质疏松男性的最佳截断值为-3.5；其敏感性和特异性分别为47.3%和76.8%。OSTA的AUC为0.676。QUS-T评分的最佳截断值为-1.25，敏感性为80.4%，特异性为59.7%。QUS-T评分的AUC为0.762。将QUS与OSTA联合应用可将特异性提高至92.9%，但敏感性降至36.1%。由OSTA和QUS-T评分联合得出的新变量表现更佳，敏感性为70.1%，特异性为72.1%；该变量的AUC为0.771，大于OSTA，但与单独使用QUS无差异。总之，OSTA和QUS及其联合应用可能有助于发现骨质疏松高危人群，这可能是诊断骨质疏松的一种替代方法，尤其是在无法进行DXA测量的地区。
Zotero 插件