亚洲骨质疏松自我评估工具在骨质疏松症筛查中的作用

目的分析用亚洲骨质疏松自我评估工具指数与双能x线诊断骨质疏松症的-致性。方法对1131名受试者进行问卷调查，测量体重、身高及骨密度，计算OSTA指数。按OSTA〈-4、-4～-1和〉-1分将受试者分为骨质疏松高、中、低风险组，并按T值≤-2．5、-2．5〈T值〈-1、T值≥-1分为骨质疏松、骨量减少、骨量正常的标准进行统计学分析，用受试者工作特征曲线判断OSTA指数预测骨质疏松的价值。结果（1）腰椎T值（r=0．34，P〈0．001）、髋部T值（r=0．601，P〈0．001）与OSTA指数呈显著正相关。（2）同一年龄受试者中，男性OSTA指数高于女性，差异有统计学意义（P〈0．01），女性比男性提前10年进入骨质疏松风险。（3）低风险组占总人群的40．2％，中等风险组为32．5％，高风险组为27．3％。低、中、高3种不同风险程度人群骨质疏松症发生率分别为26．4％、58．3％和84．5％。（4）以OSTA指数与腰椎T值、髋部T值预测骨质疏松症的曲线下面积分别为0．798、0．858和0．963，三者均有统计学意义。OSTA取值越大，其敏感性越高，特异性越低，准确性相似。结论骨质疏松预防重于治疗，选择敏感性高的截点值能筛选出更多的骨质疏松危险人群。

The role of osteoporosis self-assessment tool for Asians in osteoporosis screening

Objective To investigate inpatients with bone mineral density measurement in Guangzhou First Municipal People＇s Hospital, and analyze the consistency of diagnosis on osteoporosis between Osteoporosis Self-assessment Tool for Asians index and bone mineral density T-score measured by dual-energy X-ray absorptiometry. Methods 1 131 cases were questionnaired. Weight, height and bone mineral density were measured, then calculated OSTA index. Patients were statistically analyzed and divided into high, medium and low osteoporosis-risk group by OSTA 〈 -4, -4 - -1, 〉 -1 and osteoporosis, bone loss, normal group by T-score ≤ - 2. 5, - 2. 5 〈 T-score 〈 - 1, T-score I〉 - 1. OSTA index was calculated for predicting osteoporosis by the receiver operating characteristic curves. Results （ 1 ） Lumbar spine T-score （ r = 0. 34, P 〈 0. 001 ） and hip T-score （r = 0. 601, P 〈 0. 001 ） were positively correlated with OSTA index. （2） In the same-age group, men＇s OSTA index was significant lower than that of women＇s （ P 〈 0. 01 ）, women were earlierly 10 years than men entering osteoporosis risk group. （3） Among patients, 40. 2% of the total population was low-risk group, 32. 5% was moderate risk group, 27.3% was high-risk group. In the three different osteoporosis-risk groups, OP incidence respectively was 26.4% , 58.3%, 84. 5%. （4） The Area Under Curve of predicting osteoporosis respectively were 0. 798, 0. 858, 0. 963 for OSTA index and T-score of lumbar and hip, which were statistically significant. When OSTA index was great, the diagnostic sensitivity was high and specificity was low, but the accuracy was similar. Conclusion The prevention of osteoporosis was more inportant than treatment, so we should choose the higher sensitivity cut-off point to screen out population with more osteoporosis-risk.