亚洲人骨质疏松自我筛查工具和体质量指数筛查老年骨质疏松症效果比较  

Comparison of efficiency of osteoporosis self-assessment tool for Asian and body mass index in identifying osteoporosis

作　　者：胡健[1] 欧阳晓俊[1] 刘晔[1] 陆冰[1] 傅坤发[1] 

机构地区：[1]江苏省老年医院干部保健科,南京210024

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2017年第3期246-251,共6页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：江苏省干部保健科研项目(BJ15025)

摘　　要：目的比较亚洲人骨质疏松自我筛查工具(osteoporosis self-assessment tool for Asians,OSTA)和体质量指数(body mass index,BMI)对骨质疏松症的预测效果。方法使用双能X线吸收检测仪(dual energy X-ray absorptiometry,DXA)测定50岁以上体检者5 745人(男性2 094人,女性3 651人)的骨密度(bone mineral density,BMD)值,计算OSTA指数和BMI,分别评价两者对骨质疏松症的预测效果。结果股骨颈BMD均随年龄增长而逐渐下降。OSTA指数预测股骨颈骨质疏松的受试者工作特征(receiver operating characteristic,ROC)曲线下面积女性为0.817,男性为0.797,最佳诊断切点为-1.75(女)和-1.70(男)。BMI预测男性股骨颈骨质疏松的曲线下面积(area under curves,AUC)为0.736,与OSTA指数比较,差异无统计学意义(P>0.05),最佳诊断切点为22.9 kg/m^2。女性OSTA预测股骨颈和腰椎骨质疏松的ROC曲线下面积均高于BMI(P<0.05)。结论 OSTA和BMI可用于50岁以上人群骨质疏松症筛查,女性更适合应用OSTA指数。建议OSTA最佳干预界值为-1.7,BMI预测骨质疏松的最佳切点男性为23 kg/m^2,女性为21 kg/m^2。Objective To compare the efficiency of osteoporosis self-assessment tool for Asians （OSTA） and body mass index （BMI） in identifying osteoporosis. Methods Totally 5 745 cases （2 094 male and 3 651 female） over 50 years old were included. Bone mineral density （BMD） was measured using dual energy X-ray absorptiometry （DXA）. OSTA index and BMI were calculated, and their predictive values of osteoporosis were assessed respectively. Results BMD at femoral neck was gradually decreasing with age. Area under curves （AUC） of receiver operating curve （ROC） of OSTA were 0. 817 （female） and 0. 797 （male） at femoral neck, the best cutoff values were - 1.75 （ female） and - 1.70 （male）. AUC of ROC for BMI was 0. 736 at femoral neck in male, which was similar to OSTA, and the best cutoff value was 22. 9 kg/m2 in female, AUC of ROC for OSTA were higher than BMI both at femoral neck and lumbar spine. Conclusion Both OSTA and BMI have certain predictive value in screening osteoporosis, and OSTA is superior to BMI in female. The appropriate cutoff value of OSTA is - 1.7, and the diagnosis cutoff of BMI is 23 kg/m2 for male and 21 kg/m2 for female.

关 键 词：骨质疏松 亚洲人骨质疏松自我筛查工具 体质量指数 

分 类 号：R681[医药卫生—骨科学]