Self-assessment Tool to Identify Primary Osteoporosis in Chinese Elderly Males

Abstract

Background: Validation of the effectiveness of the Osteoporosis Self-Assessment Tool for Asians (OSTA) in identifying elderly males at increased risk of primary osteoporosis has been seldom reported in China. Methods: A cross-sectional study was conducted to assess the performance of the OSTA in 245 healthy males aged ≥50 years for routine bone mineral density (BMD) scanning by dual-energy X-ray absorptiometry. The ability of OSTA to discriminate low BMD as defined by a T score ≤ −2.5 at different sites (femoral neck, total hip, and lumbar spine) was evaluated using receiver operating characteristic (ROC) curve analysis. ROC curves were generated to determine the optimal cutoff points, sensitivity, specificity, and areas under the ROC curves. Results: Of the study participants, 14% had osteoporosis, and the prevalence of osteoporosis increased progressively with age. The area under the ROC curves of the OSTA index to identify osteoporosis in the femoral neck site was 0.712 (p < 0.0001). The sensitivity and specificity of the optimal OSTA index (cutoff = 1) to identify osteoporosis based on femoral neck BMD in all males were 84% and 49%, respectively. The sensitivity of OSTA increased with age, whereas its specificity decreased with age. Sensitivity and specificity values of 70% and 68%, respectively, were obtained in 50-year-old to 69-year-old males. Conclusion: The OSTA index may be a useful tool for identifying primary osteoporosis as defined by dual-energy X-ray absorptiometry at the femoral neck site in males aged ≥50 years, especially in males aged <70 years.

Keywords

• elderly
• osteoporosis
• screening
• sensitivity
• specificity