中国大陆地区妇女骨质疏松筛选工具探讨

目的建立适用于中国大陆地区40岁及以上妇女的骨质疏松（osteoporosis，OP）筛选工具。方法以20～39岁妇女腰椎骨密度的均数和标准差作为参考值计算T—score。以双能X线骨密度仪（dual—energy X—ray absorptiometry，DxA）的测量结果作为金标准，采用二分类的Bayes判别分析，建立判别函数。结果我国大陆地区40岁及以上妇女OP筛选工具（osteoporosis screening tool for Chinese，OSTC）为：体重-2×年龄＋50。判别准则为OSTC〉0为无OP危险性，OSTC≤0为有OP危险性。OSTC的正判率为75．78％，灵敏度为76．8％，特异度为75．1％，Kappa值为0．51（P=0．000），说明OSTC与DXA的判定结果一致性尚可。结论OSTC是一个简便的OP筛选工具。根据年龄、体重两个变量的简单计算，即可对我国大陆地区40岁及以上的妇女进行OP危险性的筛选。但OSTC没有得到外部数据的验证，其优劣还有待进一步评价。

A STUDY ON OSTEOPOROSIS SCREENING TOOL FOR CHINESE WOMEN

OBJECTIVE: To establish an osteoporosis screening tool for Chinese 40-years-old or above women. METHODS: The T-score was calculated based on the mean bone mineral density (BMD) of 20-39 years women. Considering the result of dual-energy X-ray absorptiometry(DXA) as the golden criteria, the Bayes discriminant analysis was employed to explore the function. RESULTS: The formula of the screening tool for Chinese 40-years-old or above women as following:osteoporosis screenig tool for Chinese (OSTC):Weight-2 x age+50. OSTC< or =0 was classified into high risk, OSTC>0 was low risk. The hit rate of OSTC was 75.78%. The sensitivity is 76.8%. The specificity is 75.1%, Kappa value was 0.51(P= 0.000). That means the consistency of diagnosis result between OSTC and DXA was relatively good. CONCLUSION: OSTC is a simple tool. Just based on age and weight, it can evaluate the osteoporosis risk of Chinese 40-years-old or above women. But the effect of OSTC has not been proved by other dataset and should be tested further.