Predicting the risk of osteopenia for women aged 40–55 years

Abstract

Osteoporosis has been linked to an increased fracture risk and subsequent mortality in the later life. Previous prediction models have focused on osteoporosis in postmenopausal women; however, a prediction tool for osteopenia is needed. Our objective was to establish a prediction model for osteopenia risk in women aged 40–55 years. Methods: This was a cross-sectional study. A total of 1350 Taiwanese women aged 40–55 years were recruited from a health checkup center from 2009 to 2010. The main outcome measure was osteopenia (−1≥bone mineral density T-score > −2.5). Results: The Osteoporosis Preclinical Assessment Tool (OPAT) developed in this study was based on variables with biological importance to osteopenia and variables that remained significant (p<0.05) in the multivariable analysis, which include age, menopausal status, weight, and alkaline phosphatase level. The OPAT has a total score that ranges from 0 to 7, and categorizes women into high-, moderate-, and low-risk groups. The predictive ability of the OPAT (area under the receiver operating characteristic curve=0.77) was significantly better than that of the Osteoporosis Self-assessment Tool for Asians (area under the receiver operating characteristic curve=0.69). The inclusion of serum total alkaline phosphatase level in the model, which is easy to obtain from routine health checkups, significantly enhanced the sensitivity (McNemar test, p=0.004) for detecting osteopenia in women aged 40–55 years. Conclusion: Our findings provide an important tool for identifying women at risk of osteoporosis at the preclinical phase.

Keywords

• osteopenia
• osteoporosis
• prediction model
• women