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一种用于绝经后女性骨质疏松症的新型临床诊断筛查模型的开发与验证

Development and Validation of a New Clinical Diagnostic Screening Model for Osteoporosis in Postmenopausal Women.

作者信息

Leeyaphan Jirapong, Rojjananukulpong Karn, Intarasompun Piyapong, Peerakul Yuthasak

机构信息

Bamrasnaradura Infectious Diseases Institute, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.

出版信息

J Bone Metab. 2023 May;30(2):179-188. doi: 10.11005/jbm.2023.30.2.179. Epub 2023 May 31.

Abstract

BACKGROUND

Age and weight are not only strong predictive parameters for osteoporosis diagnosis but can also be easily acquired from patients. This study aimed to develop and validate a new diagnostic screening model for postmenopausal osteoporosis that uses only 2 parameters, viz., age and weight. The discriminative ability of the model was analyzed and compared with that of the osteoporosis self-assessment tool for Asians (OSTA) index.

METHODS

The age-weight diagnostic screening model was developed using a retrospective chart review of postmenopausal women aged ≥50 years who underwent dual energy X-ray absorptiometry at a tertiary hospital from November 2017 to April 2022. Logistic regression analysis was used to derive a diagnostic screening model for osteoporosis.

RESULTS

A total of 533 postmenopausal women were included in the study. According to the highest Youden index value, a probability cut-off value of 0.298 was used in the diagnosis screening model at any site, which yielded a sensitivity of 84.3% and a specificity of 53.8%. For increased sensitivity as a screening tool, a cut-off value of 0.254 was proposed to obtain a sensitivity of 90.2% and a specificity of 42.2%. The area under receiver operating characteristic curves from all screening models were significantly higher than those from the OSTA index model (p<0.05).

CONCLUSIONS

This study showed the feasibility of a postmenopausal osteoporosis diagnostic screening model that uses 2 strong predictors for osteoporosis diagnosis: age and weight. This age-weight diagnostic model is a simple, effective option in postmenopausal osteoporosis screening.

摘要

背景

年龄和体重不仅是骨质疏松症诊断的有力预测参数,而且可以很容易地从患者那里获取。本研究旨在开发并验证一种仅使用年龄和体重这两个参数的绝经后骨质疏松症诊断筛查新模型。分析了该模型的判别能力,并与亚洲人骨质疏松自我评估工具(OSTA)指数的判别能力进行了比较。

方法

通过回顾性查阅2017年11月至2022年4月在一家三级医院接受双能X线吸收法检查的年龄≥50岁的绝经后女性的病历,开发了年龄-体重诊断筛查模型。采用逻辑回归分析得出骨质疏松症的诊断筛查模型。

结果

共有533名绝经后女性纳入本研究。根据最高约登指数值,在任何部位的诊断筛查模型中使用的概率截断值为0.298,其灵敏度为84.3%,特异度为53.8%。作为一种筛查工具,为提高灵敏度,建议截断值为0.254,以获得90.2%的灵敏度和42.2%的特异度。所有筛查模型的受试者工作特征曲线下面积均显著高于OSTA指数模型(p<0.05)。

结论

本研究表明了一种绝经后骨质疏松症诊断筛查模型的可行性,该模型使用了两个用于骨质疏松症诊断的有力预测指标:年龄和体重。这种年龄-体重诊断模型是绝经后骨质疏松症筛查中一种简单、有效的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/205d/10346005/c1bfdfca484a/jbm-2023-30-2-179f1.jpg

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