CAJ | 학술논문

目的评价在老年男性中亚洲人骨质疏松自我筛查工具(OSTA)的诊断价值.方法 2008至2010年在解放军总医院老年门诊收集行双能X线吸收法(DXA)测定骨密度的老年男性研究对象 382人.以WHO骨质疏松诊断标准分3组,即骨量正常组、低骨量组和骨质疏松组,按年龄分为3组,60~70岁组,71~80岁组和>80岁组.采用Spearman分析各部位骨密度与OSTA指数的相关性.以DXA法诊断骨质疏松为标准,比较OSTA指数评价骨质疏松症风险的灵敏度、特异度、符合率、Youden指数.结果本组人群骨质疏松患病率为9.42%,低骨量42.67%.在骨量正常组、低骨量组、骨质疏松组间,年龄逐渐增大,OSTA指数、骨密度(包括股骨颈、大转子、全髋部、腰椎L1~L4)、体重逐渐下降(P<0.01).在年龄渐增3组间,骨量正常的百分比逐渐下降,分别为60.68%、51.97%、33.33%,>80岁组骨质疏松者明显增加(24.64%),占全部骨质疏松的94.44%.OSTA指数评分显示,随年龄增加,3组间骨质疏松中风险和高风险百分比逐渐增加(P<0.01).Spearman相关分析显示,OSTA指数与股骨颈、大转子、全髋部骨密度的相关系数分别为0.33、0.28、0.29 (P<0.01),与腰椎L1~L4骨密度的相关系数0.06(P>0.05).以T值≤-1为切点,OSTA指数≤-1诊断的灵敏度、特异度、符合率、Youden指数分别为56.28%、64.48%、60.21%、0.21;以T值≤-2.5为切点,上述指标分别为86.11%、57.80%、60.47%和0.44.结论 OSTA指数与骨密度存在相关性;OSTA指数评价骨质疏松症风险的灵敏度、特异度、诊断符合率较好,可作为骨质疏松诊断简单的筛查工具.
목적 평개재노년남성중아주인골질소송자아사사공구(OSTA)적진단개치.방법 2008지2010년재해방군총의원노년문진수집행쌍능X선흡수법(DXA)측정골밀도적노년남성연구대상 382인.이WHO골질소송진단표준분3조,즉골량정상조、저골량조화골질소송조,안년령분위3조,60~70세조,71~80세조화>80세조.채용Spearman분석각부위골밀도여OSTA지수적상관성.이DXA법진단골질소송위표준,비교OSTA지수평개골질소송증풍험적령민도、특이도、부합솔、Youden지수.결과 본조인군골질소송환병솔위9.42%,저골량42.67%.재골량정상조、저골량조、골질소송조간,년령축점증대,OSTA지수、골밀도(포괄고골경、대전자、전관부、요추L1~L4)、체중축점하강(P<0.01).재년령점증3조간,골량정상적백분비축점하강,분별위60.68%、51.97%、33.33%,>80세조골질소송자명현증가(24.64%),점전부골질소송적94.44%.OSTA지수평분현시,수년령증가,3조간골질소송중풍험화고풍험백분비축점증가(P<0.01).Spearman상관분석현시,OSTA지수여고골경、대전자、전관부골밀도적상관계수분별위0.33、0.28、0.29 (P<0.01),여요추L1~L4골밀도적상관계수0.06(P>0.05).이T치≤-1위절점,OSTA지수≤-1진단적령민도、특이도、부합솔、Youden지수분별위56.28%、64.48%、60.21%、0.21;이T치≤-2.5위절점,상술지표분별위86.11%、57.80%、60.47%화0.44.결론 OSTA지수여골밀도존재상관성;OSTA지수평개골질소송증풍험적령민도、특이도、진단부합솔교호,가작위골질소송진단간단적사사공구.
Objective To evaluate the diagnostic values of osteoporosis self-assessment tool for Asians (OSTA) in aged men.Methods Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) in 382 male outpatients. Their data were collected. After excluding such influencing factors of BMD as diseases or drugs, they were divided into 3 groups according to the WHO osteoporosis diagnosis value or age. The correlation between OSTA index and BMD was analyzed by Spearman correlation. The concordance of OSTA and BMD were calculated and analyzed by a four-fold table.ResultsThe prevalence of osteoporosis was 9.42% and osteopenia 42.67%. Age increased gradually in the osteoporosis, osteopenia and normal bone mass groups. But OSTA index, BMD (including lumbar vertebrae L1-4, femoral neck, trochanter and hip) and weight decreased gradually in those groups. The percent of normal bone mass decreased with advancing age. And the percentages were 60.68%, 51.97% and 33.33% respectively. Osteoporosis increased in the older group (>80 years old) and the percentage was 24.64% accounting for 94.44% of all osteoporotic subjects. Judging by the OSTA index, the rate of low osteoporotic risk decreased with advancing age. But the rates of mid-risk and high-risk increased. The correlation coefficients of OSTA index and BMD in femoral neck, trochanter, hip and L1-4 was 0.33, 0.28, 0.29 and 0.06 respectively. And the correlation between OSTA index and BMD had statistical significance except for L1-4. The sensitivity, specificity, coincidence and Youden index of OSTA index with a T score cutoff of -1 of BMD were 56.28%, 64.48%, 60.21% and 0.21 respectively versus 86.11%, 57.80%, 60.47% and 0.44 with a T score cutoff of -2.5.Conclusion Correlation exists between OSTA index and BMD. The sensitivity, specificity and coincidence of OSTA index are excellent based upon the standard of BMD by DXA. It is a useful and simple diagnostic tool of osteoporosis.