Evaluation of two tools for the early screening of osteoporosis in postmenopausal Chinese women with type 2 diabetes mellitus

Abstract

Objective: To evaluate two osteoporosis screening tools, the osteoporosis self-assessment tool for Asians (OSTA) and the osteoporosis screening tool for Chinese (OSTC), in postmenopausal Chinese women with type 2 diabetes mellitus (T2DM). Methods: This retrospective study enrolled postmenopausal female patients with T2DM. Bone mineral density at the lumbar spine (L1-4) and left femoral neck was measured using dual-energy X-ray absorptiometry (DXA). The OSTA and OSTC scores were calculated and compared with bone mineral density at the two anatomical sites. Results: A total of 404 patients with T2DM were enrolled in this study. The detection rates for osteoporosis in the lumbar spine (L1-L4) and left femoral neck by DXA were 22.5% (91 of 404 patients) and 21.8% (88 of 404 patients), respectively; 14.4% (58 of 404 patients) and 18.1% (73 of 404 patients) by OSTA, respectively; and 21.5% (87 of 404 patients) at both sites by OSTC. At the femoral neck, the areas under the curve (AUC) of OSTA and OSTC for predicting osteoporosis were 0.73 and 0.78, respectively. The sensitivity and specificity for OSTA were 64.9% and 72.7%, respectively; and for OSTC, they were 64.2% and 79.5%, respectively.

Evaluation of community-based screening tools for the early screening of osteoporosis in postmenopausal Vietnamese women

“…The groups with the high-risk scores (OSTA score < -1, OSTC score ≤ 0) were predominant in our samples, which is consistent with previous studies [ 16 , 24 , 35 ]. The tool-based prevalence in this study was notably higher than that of Subramaniam et al [ 36 ] in a sample with quite similar characteristics, namely Malaysians over the age of 39.…”

“…In general, the predictive value was similar between the two tools. For OSTA, the AUC values for the lumbar vertebrae varied from 70.9% to 73.9%, which is similar to those of Fan et al [ 39 ] and higher than those of Tang et al [ 16 ]. Although the sensitivity of OSTA with the Vietnamese sample (58.4%– 73.7%) varied more widely than the Chinese sample (65%) [ 16 ], specificity was higher (62.7%– 77.4% vs. 48.9%) [ 16 ].…”

“…To investigate the accuracy of OSTA and OSTC in osteoporosis prediction, WHO criteria were applied as the reference standard for the diagnosis of osteoporosis at anatomical sites. While OSTA has been widely assessed in Asia [ 16 , 32 , 35 , 37 – 41 ], evidence for OSTC is still limited. In our study, the validity of two tools was assessed for different sites, with the results obtained for femoral necks being better than those for lumbar vertebrae.…”

“…This issue highlights the need for rapid and cost-effective screening tools for osteoporosis to overcome the limitations of DXA in the context of community-based screening. Although many screening tools for predicting osteoporosis and fracture risk have been published and show promising performance, with sensitivities up to 91% [ 16 – 23 ], local differences mean that there are challenges in using these tools in different nations.…”

“…The osteoporosis self-assessment tool for Asians (OSTA) and the osteoporosis screening tool for Chinese (OSTC) have been developed and evaluated in Asia countries [ 16 , 24 , 25 ]. These are simple tools, using only weight and age as predictors, and they are appropriate in the context of community-based screening and low-resource settings.…”