Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
Fangzhuang Community Health Service Center, Beijing, People's Republic of China.
Clin Interv Aging. 2023 May 24;18:845-853. doi: 10.2147/CIA.S410239. eCollection 2023.
This cross-sectional study estimated three clinical tools including the Osteoporosis Self-Assessment Tool for Asians (OSTA), Body Mass Index (BMI), and Beijing Friendship Hospital Osteoporosis Self-assessment Tool for Elderly Male (BFH-OSTM) for identifying primary osteoporosis and found optimal cut-off values in an elderly Han Beijing male population.
We conducted a cross-sectional study, enrolling 400 community-dwelling elderly Han Beijing males aged ≥50 from 8 medical institutions. Osteoporosis was diagnosed as a T-score of -2.5 standard deviations or lower than that of the average young adult in different diagnostic criteria [lumbar spine (L1-L4), femoral neck, total hip, WHO]. BFH-OSTM, OSTA, and BMI were assessed for predicting OP by receiver operating characteristic (ROC) curves. Sensitivity, specificity, and areas under the ROC curves (AUC) were determined. Ideal thresholds for the omission of screening BMD were proposed.
The prevalence of osteoporosis ranged from 9.25% to 19.0% according to different diagnostic criteria. The present study indicated the highest discriminating ability was BFH-OSTM in different criteria. The AUCs of OSTA and BMI were 0.748 and 0.770 in WHO criteria, which suggested limiting predictive value for identifying OP in elderly Beijing males. The AUC of BFH-OSTM to predict OP based on WHO criteria was 0.827, yielding a sensitivity of 65.8% and specificity of 82.7%, respectively. With a cost of missing 6.5% of osteoporosis patients, BFH-OSTM could reduce 73.5% of participants in screening BMD tests.
BFH-OSTM may be a simple and effective tool for identifying OP in the elderly male population in Beijing to omit BMD screening reasonably.
本横断面研究旨在评估三种临床工具，包括亚洲人骨质疏松自我评估工具（OSTA）、体重指数（BMI）和北京友谊医院老年男性骨质疏松自我评估工具（BFH-OSTM），以识别原发性骨质疏松症，并在老年汉族北京男性人群中找到最佳截断值。
我们进行了一项横断面研究，共纳入 8 家医疗机构的 400 名年龄≥50 岁的社区居住的汉族北京男性。骨质疏松症的诊断标准为不同诊断标准中 T 值低于-2.5 个标准差或低于年轻成人平均水平[腰椎（L1-L4）、股骨颈、全髋、WHO]。通过接受者操作特征（ROC）曲线评估 BFH-OSTM、OSTA 和 BMI 对预测 OP 的能力。确定了灵敏度、特异性和 ROC 曲线下面积（AUC）。提出了理想的筛查 BMD 阈值。
根据不同的诊断标准，骨质疏松症的患病率在 9.25%至 19.0%之间。本研究表明，不同标准下 BFH-OSTM 的区分能力最高。OSTA 和 BMI 在 WHO 标准中的 AUC 分别为 0.748 和 0.770，提示对识别北京老年男性 OP 的预测价值有限。基于 WHO 标准，BFH-OSTM 预测 OP 的 AUC 为 0.827，灵敏度为 65.8%，特异性为 82.7%。以漏诊 6.5%的骨质疏松症患者为代价，BFH-OSTM 可减少 73.5%的参与者进行 BMD 筛查。
BFH-OSTM 可能是一种简单有效的工具，可用于合理地排除北京老年男性人群的 BMD 筛查，以识别 OP。
