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Authors Lin J, Yang Y, Zhang X, Ma Z, Wu H, Li Y, Yang X, Fei Q, Guo A
Received 27 April 2017
Accepted for publication 27 June 2017
Published 31 July 2017 Volume 2017:12 Pages 1167—1174
DOI https://doi.org/10.2147/CIA.S140553
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Professor Zhi-Ying Wu
Purpose: To develop and validate a new clinical screening tool to identify
primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in two elderly
Han Chinese male populations.
Methods: A cross-sectional study was conducted, enrolling 1,870
community-dwelling and 574 hospital-checkup elderly Han Chinese males aged ≥50
years. All subjects completed a structured questionnaire and had their bone
mineral density (BMD) measured using DXA. Using logistic regression analysis in
the 1,870 community-dwelling males, we assessed the ability of numerous
potential clinical risk factors to identify male with osteoporosis. Multiple
variable regression analysis and item reduction yielded a final tool named the
Beijing Friendship Hospital Osteoporosis Self-assessment Tool for Elderly Male
(BFH-OSTM). Receiver operating characteristic (ROC) curve was generated to
compare the validation of the BFH-OSTM and Osteoporosis Self-assessment Tool
for Asians (OSTA) for identifying elderly male at increased the risk of primary
osteoporosis in the 574 hospital-checkup males.
Results: In screening the 1,870 community-dwelling subjects with DXA, 14.2%
(266/1,870) had osteoporosis, and a further 51.8% (969/1,870) had osteopenia.
Of the items screened in the questionnaire, weight, height and previous history
of fragility fracture were predictive of osteoporosis. A final tool (BFH-OSTM)
was based on body weight and fragility fracture history only. The BFH-OSTM
index (cutoff =70) had a sensitivity of 85% and specificity of 53% for
identifying osteoporosis according to the WHO criteria, with an area under the
ROC curve of 0.763. The predictive value of BFH-OSTM was validated in the 574
hospital-checkup population, which performed better than OSTA.
Conclusion: The BFH-OSTM may perform well for identifying elderly male at increased
risk for osteoporosis and applying it would result in more prudent use of BMD
measurement by DXA, especially for Han Chinese male.
Keywords: osteoporosis, bone mineral density, male, risk factors, screening