Association of OSTA index with bone mineral density (BMD) and its comparison with calcaneal quantitative ultrasound for the prediction of low BMD in peri-menopausal Indian women
Keywords:
Osteoporosis, Osteopenia, OSTA index, Calcaneal, Quantitative ultrasound, Bone mineral density, Peri-menopausal womenAbstract
Background: Osteoporosis is characterized by low bone mineral density (BMD) and an increased risk of fractures with advancing age in postmenopausal women. BMD measurements with dual energy X-ray absorptiometry (DEXA) are costly and not widely available The Osteoporosis Self-Assessment Tool for Asians (OSTA) index is a simple tool based on age and body weight to predict low BMD and identify women at risk of osteoporosis. The objective was to study the association of OSTA index with BMD (T-score) and to validate OSTA index in comparison with calcaneal Quantitative Ultrasound (QUS) for the prediction of low BMD in peri-menopausal Indian women.
Methods: This was a prospective, cross-sectional, descriptive study carried out in department of physiology of a tertiary care teaching hospital (Navi Mumbai). Seventy two peri-menopausal women between 40 to 55 years with no previous diagnosis of osteoporosis were included. Participants’ socio-demographic detail, anthropometric measurements, OSTA index and QUS-based BMD was recorded. Pearson’s correlation test was used. Sensitivity, specificity, positive and negative predictive value was calculated.
Results: OSTA index did not correlate with BMD in the entire samples. On subgroup analysis, OSTA index significantly correlated in a positive direction with BMD (T-score) in women in the age group of 50-55 years. OSTA index had a sensitivity of 70 %, and specificity of 84.62 % at T-score cutoff value of < -1.
Conclusions: OSTA index is a simple risk assessment tool that can be used to identify women with low BMD in the age group of 50-55 years.
References
Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002;359(9321):1929-36.
Lau EM, Lee JK, Suriwongpaisal P, Saw SM, Das De S, Khir A, Sambrook P. The incidence of hip fracture in four Asian countries: the Asian Osteoporosis Study (AOS). Osteoporos Int. 2001; 12(3):239-43
Sambrook P, Cooper C. Osteoporosis. Lancet. 2006; 367(9527):2010-18.
Siris ES1, Brenneman SK, Barrett-Connor E, Miller PD, Sajjan S, Berger ML, Chen YT. The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in postmenopausal women aged 50-99: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int. 2006;17(4):565-74.
Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994;4(6):368-81.
Weinstein L, Ullery B, Bourguignon C. A simple system to determine who needs osteoporosis screening. Obstet Gynecol. 1999;93(5 Pt 1):757-60.
Skedros JG, Sybrowsky CL, Stoddard GJ. The osteoporosis self-assessment screening tool: a useful tool for the orthopaedic surgeon. J Bone Joint Surg Am. 2007;89(4):765-72.
Koh LK, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP, Huang QR, Rajatanavin R, Tsai KS, Park HM, Reginster JY; Osteoporosis Self-Assessment Tool for Asians (OSTA) Research Group. A simple tool to identify Asian women at increased risk of osteoporosis. Osteoporos Int. 2001; 12(8):699-705.
Muslim DAJ, Mohd EF, Sallehudin AY, Tengku Muzaffar TMS, Ezane ASM. Performance of Osteoporosis Self-assessment Tool for Asian (OSTA) for Primary Osteoporosis in Post-menopausal Malay Women. Malaysian Orthopaedic Journal. 2012;6(1):35-39.
Reid IR. Relationships among body mass, its components, and bone. Bone. 2002;31(5):547-55.
Felson DT, Zhang Y, Hannan MT, Anderson JJ. Effects of weight and body mass index on bone mineral density in men and women: the Framingham study. J Bone Miner Res. 1993;8(5): 567-73.
Morin S, Tsang JF, Leslie WD. Weight and body mass index predict bone mineral density and fractures in women aged 40 to 59 years. Osteoporos Int. 2009;20(3):363-70.
Salamat MR, Salamat AH, Abedi I, Janghorbani M. Relationship between Weight, Body Mass Index, and Bone Mineral Density in Men Referred for Dual-Energy X-Ray Absorptiometry Scan in Isfahan, Iran. J Osteoporos. 2013;2013:205963.
Damilakis J, Maris TG, Karantanas AH: An update on the assessment of osteoporosis using radiologic techniques. Eur Radiol. 2007;17(6):1591-1602
Glüer CC. Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. The International Quantitative Ultrasound Consensus Group. J Bone Miner Res. 1997;12(8):1280-8.
Díez-Pérez A, Marín F, Vila J, Abizanda M, Cervera A, Carbonell C, Alcolea RM, Cama A, Rama T, Galindo E, Olmos C. Evaluation of calcaneal quantitative ultrasound in a primary care setting as a screening tool for osteoporosis in postmenopausal women. J Clin Densitom. 2003;6(3):237-45.
Chin KY, Ima-Nirwana S. Calcaneal Quantitative Ultrasound as a Determinant of Bone Health Status: What Properties of Bone Does It Reflect?. Int J Med Sci 2013; 10(12):1778-1783. Available from http:/ /www.medsci.org/v10p1778.htm
Collinge CA, Lebus G, Gardner MJ, Gehrig L. A comparison of quantitative ultrasound of the calcaneus with dual-energy x-ray absorptiometry in hospitalized orthopaedic trauma patients. J Orthop Trauma. 2010;24(3):176-80.
Sherchan B, Lamichhane A, Mahara DP. Osteoporosis Self Assessment Tool for Asian (OSTA) Index in Comparison to Quantitative Ultrasound of the Calcaneal in Predicting Low Bone Density. Nepal Orthopaedic Association Journal. 2013;3(2):20-25.
Lu C, Chen D, Cai Y, Wei S. Concordane of OSTA and lumbar spine BMD by DXA in identifying risk of osteoporosis. J Orthop Surg Res. 2006;1:14.
Pongchaiyakul C, Nguyen ND, Eisman JA, Nguyen TV. Clinical risk indices, prediction of osteoporosis, and prevention of fractures: diagnostic consequences and costs. Osteoporos Int. 2005; 16(11): 1444-50.
Chaovisitsaree S, Namwongprom SN, Morakote N, Suntornlimsiri N, Piyamongkol W. Comparison of osteoporosis self assessment tool for Asian (OSTA) and standard assessment in Menopause Clinic, Chiang Mai. J Med Assoc Thai. 2007;90(3): 420-5.
Wiriyasirivaj B. Screening of Osteoporosis in Menopausal Women using OSTA Index and KKOS Scoring System. Vajira Med J. 2010;54:135-146.
