Evaluation of the Predictive Index for Osteoporosis as a Clinical Tool to Identify the Risk of Osteoporosis in Korean Men by Using the Korea National Health and Nutrition Examination Survey Data

Abstract

BackgroundWe previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey.MethodsParticipants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared.ResultsBoth indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737.ConclusionThe Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50–69 years.

Prognostic performance of Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians in the identification of individuals high-risk for osteoporosis

“…However, the sensitivity and specificity of OSTA, 71.9% and 64.0%, respectively, and the sensitivity and specificity of PIO, 67.6% and 72.7%, respectively, was higher than the results of our study. The difference in the results of our study may be because of the differences in the population characteristics since our study included both men and women, and the prevalence of osteoporosis in our study was found to be higher at 40.7% as compared to the above study which was at 4.9% [ 19 ].…”

“…Assessment of smoking status for the prediction of osteoporosis was supported by recent research results such as in the Framingham study wherein current smokers exhibited greater bone loss than former or never smokers [ 17 ]. Although in a similar study conducted by Moon et al, their results also showed that there was no statistically significant difference between the 2 ROC graphs of OSTA and PIO [ 19 ]. However, the sensitivity and specificity of OSTA, 71.9% and 64.0%, respectively, and the sensitivity and specificity of PIO, 67.6% and 72.7%, respectively, was higher than the results of our study.…”

“…In the study conducted by Moon et al they reported their mean OSTA index to be 1.77 ± 0.02 in the normal or osteopenia group and 1.54 ± 0.07 in the osteoporosis group which was significantly different. The mean PIO between the 2 groups, 0.95 ± 0.00 in the normal or osteopenia group and 1.03 ± 0.01 in the osteoporosis group, was also found to be significantly different [ 19 ].…”

“…The DXA machine measured lumbar spines (L1-L4), right femoral neck, left femoral neck. Osteoporosis was defined according to the World Health Organization Criteria with a T score ≤ −2.5 SD on DXA in the mean of lumbar spines (L1–4), femoral neck, or total femur [ 19 ].…”

Association between body mass index and fragility fracture in postmenopausal women: a cross-sectional study using Korean National Health and Nutrition Examination Survey 2008-2009 (KNHANES IV)

“…Individuals with osteoporosis have a higher risk for fragility fractures due to reduced bone density, and increased risk for resulting complications and mortality rates. (2) Fragility fracture refers to a non-traumatic fracture and, according to the World Health Organization (WHO), is de ned as a fracture caused by a fall from a level below one's height, including fracture(s) caused by impact that do not cause fracture(s) in normal bones, and even when that impact is not recognized. (3) In Korea, women > 50 (59.5%) are more likely to experience fragility fractures in their lifetime than men > 50 (23.8%) years of age.…”