An assessment of the use of quantitative ultrasound and the Osteoporosis Self-Assessment Tool for Asians in determining the risk of nonvertebral fracture in postmenopausal Chinese women |
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Authors: | Bei Tao Jian-min Liu Xiao-ying Li Ji-guang Wang Wei-qing Wang Guang Ning |
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Institution: | (1) Department of Endocrine and Metabolic Diseases, Shanghai Rui-jin Hospital, Jiaotong University, School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China;(2) Institute of Hypertension, Shanghai, China |
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Abstract: | This cross-sectional study aims to assess the effectiveness of a simple, noninvasive scoring system, the Osteoporosis Self-Assessment
Tool for Asians (OSTA), and quantitative bone ultrasound (QUS) in assessing nonvertebral fracture risk in Chinese postmenopausal
women. A group of 513 community-dwelling women including 271 postmenopausal individuals participated in this study. Speed
of sound (SOS m/s) at the radius, phalanx, and tibia were assessed by using the Omnisense prototype (Sunlight Ltd., Israel).
Body height and weight were measured, and body mass index (BMI) and OSTA indices were calculated. Self-reported fractures
were identified using a structured questionnaire. Phalanx SOS was significantly lower among postmenopausal women with a history
of nonvertebral fracture occurred after menopause than those without (3755 m/s vs. 3841 m/s, P = 0.017, adjusted for age and weight), with an AUC of 0.66. The AUC of the OSTA for predicting nonvertebral fracture occurred
after menopause was 0.64. SOS at the radius, phalanx, and tibia showed a positive correlation with OSTA index (r = 0.376–0.401, P < 0.001). The prevalence of nonvertebral fractures also increased significantly with the decreasing order of OSTA index (χ2 = 5.432, P = 0.02). The OSTA values of ≤−1 and phalanx QUS T-score of ≤−1.95 can differentiate postmenopausal nonvertebral fracture
with sensitivity of 75% and 81%, respectively, and specificity of 48% and 40%, respectively. Combining OSTA and phalanx QUS
yielded a sensitivity of 83% and a specificity of 84% to detect postmenopausal nonvertebral fracture, with an AUC of 0.64.
We conclude that OSTA and phalanx QUS are simple and effective clinical tools for identifying postmenopausal women at increased
risk of nonvertebral fractures and can thereby facilitate the appropriate and more cost-effective use of bone densitometry
to prevent osteoporotic fractures in developing countries. |
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Keywords: | bone density fracture OSTA speed of sound quantitative ultrasound |
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