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Performance of risk indices for identifying low bone density in postmenopausal women.

Abstract：

OBJECTIVE:To examine the ability of 4 published osteoporosis risk indices to identify women with low bone density. SUBJECTS AND METHODS:Subjects included postmenopausal women 45 years and older consecutively recruited from US clinics, women from general practice centers in The Netherlands (age range, 50-80 years), women in the Rotterdam Study (The Netherlands) 55 years and older, and women aged 55 to 81 years old screened for a clinical trial of alendronate. Bone mineral density (BMD) was measured at the femoral neck or lumbar spine; T scores represent the number of SDs below the mean for young healthy women. One risk index was calculated from age and weight; the other risk indices included up to 4 additional variables obtained by questionnaire. We calculated the sensitivity and specificity for identifying women with BMD T scores of -2.5 or less or -2.0 or less in the US clinic sample and created 3 risk categories, using each of the 4 indices. RESULTS:Data were available for 1102 women from the US clinic sample, 3374 women in the Rotterdam Study, 23,833 women screened for a clinical trial of alendronate, and 4204 women from general practice centers in The Netherlands. Specificity for identifying BMD T scores of -2.5 or less ranged from 37% to 58% (depending on risk index) when sensitivity was approximately 90%. The prevalence of osteoporosis (defined as T scores < or = -2.5) differed widely across the 3 risk categories, ranging from 2% to 4% for the low-risk category to 47% to 61% for the high-risk category in the US clinic sample. For spine BMD in the US clinic sample, the prevalence of T scores of -2.5 or less ranged from 7% (low risk) to 38% (high risk). The large differences in prevalence across risk categories were consistent across the other 3 samples of postmenopausal women in the United States and The Netherlands for all 4 risk indices. CONCLUSIONS:We recommend measuring BMD in women who are classified as having an increased risk of osteoporosis by using any of these risk indices because all 4 indices appear to predict low bone mass equally well. The Osteoporosis Self-assessment Tool index is easiest to calculate and therefore may be most useful in clinical practice.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Geusens P,Hochberg MC,van der Voort DJ,Pols H,van der Klift M,Siris E,Melton ME,Turpin J,Byrnes C,Ross P

doi

10.4065/77.7.629

keywords:

subject

Has Abstract

pub_date

2002-07-01 00:00:00

pages

629-37

issue

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(11)62229-5

journal_volume

pub_type

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Performance of risk indices for identifying low bone density in postmenopausal women.