Tang Yuchen, Hu Xin, Dong Wen, Qin Jun, Shu Jianchuan, Kuang Jiaxin, Wang Qiufu, Jiang Guanyin, Lei Miao, Wu Yongle, Hao Jie, Hu Zhenming
Department of Orthopedics, University-Town Hospital of Chongqing Medical University, Daxuecheng Middle Road No. 55, Shapingba District, Chongqing, 401331, China.
Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang Youyi Road No. 1, Yuzhong District, Chongqing, 400010, China.
Eur J Med Res. 2025 Sep 26;30(1):861. doi: 10.1186/s40001-025-03104-2.
This study aimed to evaluate the efficacy of the Primary Osteoporosis Screening Tool (POST) in identifying osteoporosis among Chinese adults aged 50 years and older.
This retrospective cross-sectional study consecutively included patients from the University-Town Hospital of Chongqing Medical University. Osteoporosis was defined based on the T-scores of femoral neck bone mineral density (BMD) or lumbar spine BMD by dual-energy X-ray absorptiometry examinations. The POST scores were computed according to the subject information on age, sex, and weight. In addition, the performance of the POST was assessed and compared with the Osteoporosis Self-assessment Tool for Asians (OSTA) by area under the receiver operating characteristic curve, net reclassification improvement (NRI), integrated discrimination improvement (IDI).
A total of 2861 patients were included in the final analysis, of whom 78.43% were women, with a mean age of 65.67 ± 9.81 years. The POST exhibited superior performance compared to OSTA in osteoporosis screening, as evidenced by a higher area under curve, enhanced NRI/IDI metrics, and remarkable sensitivity. Subgroup analysis further highlighted the superior efficacy of POST in individuals aged 65 years and older. Additionally, sensitivity analysis confirmed that the POST maintained robust performance in identifying individuals with osteoporosis, even after the exclusion of underweight patients.
The POST has been shown to be an effective instrument for osteoporosis screening among Chinese adults. Nonetheless, this study has limitations including its single-center retrospective design and imbalanced gender distribution, which may affect generalizability.
本研究旨在评估原发性骨质疏松筛查工具（POST）在50岁及以上中国成年人中识别骨质疏松症的有效性。
这项回顾性横断面研究连续纳入了重庆医科大学大学城医院的患者。骨质疏松症根据双能X线吸收法检查测得的股骨颈骨密度（BMD）或腰椎BMD的T值来定义。POST分数根据受试者的年龄、性别和体重信息计算得出。此外，通过受试者工作特征曲线下面积、净重新分类改善（NRI）、综合辨别改善（IDI）对POST的性能进行评估，并与亚洲人骨质疏松自我评估工具（OSTA）进行比较。
最终分析共纳入2861例患者，其中78.43%为女性，平均年龄为65.67±9.81岁。POST在骨质疏松症筛查中的表现优于OSTA，曲线下面积更高、NRI/IDI指标增强以及灵敏度显著等都证明了这一点。亚组分析进一步突出了POST在65岁及以上人群中的优越疗效。此外，敏感性分析证实，即使排除体重过轻的患者，POST在识别骨质疏松症患者方面仍保持稳健的性能。
POST已被证明是中国成年人骨质疏松症筛查的有效工具。尽管如此，本研究存在局限性，包括单中心回顾性设计和性别分布不均衡，这可能会影响其普遍性。
