A pilot screening study for low bone mass in Singaporean women using years since menopause and BMI

Abstract

Objective

Current risk assessment tools for osteoporosis have inconsistent performance across different cohorts, making them difficult for clinical practice. This study aimed to evaluate a simple screening index comprising years since menopause (YSM) and body mass index (BMI) that identifies postmenopausal Singaporean women with a greater likelihood of low bone mass.

Methods

The study used data from 188 treatment-naïve postmenopausal women. The associations between low bone mass and different demographic variables, including age, YSM and BMI, were assessed using multivariable logistic regression. Diagnostic performance of the calculated screening index was compared to the Osteoporosis Self-Assessment Tool for Asians (OSTA) and the Fracture Risk Assessment Tool (FRAX^®).

Results

YSM and BMI were significantly associated with low bone mass. The area under the receiver operating characteristic curves was 0.803 for the screening index, 0.759 for the OSTA, 0.683 for the FRAX^® (major osteoporotic fracture probability [MOFP]) and 0.647 for the FRAX^® (hip fracture probability [HFP]). Non-parametric Spearman’s correlation between the screening index and the other models was 0.857 with the OSTA score, 0.694 with the FRAX^® (HFP) and 0.565 with the FRAX^® (MOFP) (p < 0.0005).

Conclusions

The diagnostic performance of the screening index comprising YSM and BMI was equivalent to the OSTA and the FRAX^®. A risk chart was developed for clinicians to identify and recommend subjects for a further dual-energy X-ray absorptiometry scan. Validation of this model in larger and more diverse cohorts is required.

一项用绝经年限和BMI对新加坡女性进行低骨量筛查的初步研究 摘要

目的：目前的骨质疏松症风险评估工具在不同的队列中表现不一致, 这使得很难在临床实践中应用它们。本研究旨在评估一项简单的筛查指数, 该指数包括绝经年限（YSM）和体重指数（BMI）, 该指数可识别更可能出现低骨量的绝经后的新加坡女性。

方法：本研究采用了188名未接受过治疗的绝经后女性的数据。采用多变量Logistic回归分析低骨量与不同人口统计学变量（包括年龄、YSM和BMI）之间的关系。计算的筛查指数的诊断性能与亚洲人骨质疏松症自我评估工具（OSTA）和骨折风险评估工具（FRAX^®）进行了比较。

结果：YSM和BMI与低骨量显著相关。受试者工作特征曲线下面积筛查指数为0.803, OSTA为0.759, FRAX^®（主要骨质疏松性骨折概率[MOFP]）为0.683, FRAX^®（髋部骨折概率[HFP]）为0.647。筛查指数与其他模型之间的非参数Spearman相关系数在OSTA评分中为0.857, 在FRAX^®（HFP）0.694, 在FRAX^®（MOFP）为0.565（p<0.0005）。

结论：由YSM和BMI组成的筛查指数的诊断性能与OSTA和FRAX^®相当。为临床医生开发了一张风险图表, 以识别和推荐受试者进行进一步的双能X射线吸收测量扫描。需要在更大、更多样化的队列中验证该模型。

Keywords:

• Screening index
• low bone mass
• years since menopause
• body mass index
• OSTA
• FRAX^®

Potential conflict of interest

The authors know of no conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome.

Source of funding

Nil.