OSTA as a screening tool to predict osteoporosis in Indian postmenopausal women — a nationwide study,Archives of Osteoporosis

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OSTA as a screening tool to predict osteoporosis in Indian postmenopausal women — a nationwide study
Archives of Osteoporosis ( IF 3.1 ) Pub Date : 2022-09-10 , DOI: 10.1007/s11657-022-01159-w
Khushboo Agarwal ₁ , Kripa Elizabeth Cherian ₁ , Nitin Kapoor ₁ , Thomas V Paul ₁

Affiliation

Summary

This cross-sectional study done on 5356 postmenopausal women showed that OSTA may be used as a reliable screening tool for osteoporosis across different regions of India, a country known for its ethno-linguistic, cultural, and genetic diversity.

Background

The gold standard for diagnosing osteoporosis is DXA (dual-energy X-ray absorptiometry) scan, and this is not widely available across India. OSTA (Osteoporosis Self-Assessment Tool for Asians) score predicts risk of osteoporosis and can be used as reference tool for DXA. At a cutoff of ≤ + 1, OSTA predicted femoral neck osteoporosis with a sensitivity of 88% in a previous study among south Indian postmenopausal women. This study was done to validate the OSTA score in postmenopausal women across India.

Methodology

A cross-sectional study in 5356 postmenopausal women from four regions of India namely south, east, north, and west. Bone mineral density (BMD) and trabecular bone score (TBS) were assessed by DXA. The performance of OSTA in predicting BMD and TBS was assessed using ROC curve.

Results

The mean (SD) age was 61.6 (7.6) years. The performance of OSTA in predicting osteoporosis was fair (P < 0.001) with an AUC of 0.727 (95% CI 0.705–0.749) in the south, 0.693 (95% CI 0.664–0.723) in east India, 0.730 (95% CI 0.700–0.759) in the north, and 0.703 (95% CI 0.672–0.735) in the western region. At a cut-off below + 1.0, sensitivity was 76–84% and specificity was 45–53% in diagnosing osteoporosis at any site. In predicting degraded microarchitecture, the AUC was 0.500–0.600.

Conclusion

OSTA may be reliably used as a screening tool for women at high risk of osteoporosis across India and may circumvent the limited availability of DXA scanners across the country.

中文翻译：

OSTA 作为预测印度绝经后妇女骨质疏松症的筛查工具——一项全国性研究

概括

这项对 5356 名绝经后妇女进行的横断面研究表明，OSTA 可用作印度不同地区骨质疏松症的可靠筛查工具，印度是一个以其民族语言、文化和遗传多样性而闻名的国家。

背景

诊断骨质疏松症的金标准是 DXA（双能 X 射线吸收测定法）扫描，这在印度并未广泛使用。OSTA（亚洲人骨质疏松自我评估工具）评分预测骨质疏松风险，可作为 DXA 的参考工具。在 ≤ + 1 的截断值下，OSTA 预测股骨颈骨质疏松症的敏感性为 88%，此前一项针对南印度绝经后妇女的研究表明。这项研究旨在验证印度绝经后妇女的 OSTA 评分。

方法

对来自印度南部、东部、北部和西部四个地区的 5356 名绝经后妇女进行的横断面研究。通过 DXA 评估骨矿物质密度 (BMD) 和骨小梁评分 (TBS)。使用 ROC 曲线评估 OSTA 在预测 BMD 和 TBS 方面的性能。

结果

平均 (SD) 年龄为 61.6 (7.6) 岁。OSTA 在预测骨质疏松症方面的表现是公平的 ( P < 0.001)，AUC 在南部为 0.727 (95% CI 0.705–0.749)，在印度东部为 0.693 (95% CI 0.664–0.723)，在印度东部为 0.730 (95% CI 0.700) –0.759) 在北部，在西部地区为 0.703 (95% CI 0.672–0.735)。在低于 + 1.0 的临界点，在任何部位诊断骨质疏松症的敏感性为 76-84%，特异性为 45-53%。在预测退化的微体系结构时，AUC 为 0.500–0.600。