CAJ | 학술논문

目的观察亚洲骨质疏松自我评价工具(OSTA)对成都地区中老年男性骨质疏松、低骨量的筛查效果评价. 方法用双能X线骨密度仪(DXA)测定成都地区40岁以上健康男性4042例,测量部位包括腰椎(L1～4)、左股骨颈、大转子、Wards区、股骨干、全髋;根据公式计算OSTA得分,按OSTA＞-1、-4＜OSTA≤-1、OSTA≤-4将研究对象分为低危险性、中危险性、高危险性3级或按OSTA＞-1、OSTA≤-1分为低危险、中高危险两级双能X线骨密度仪(DXA)测定的不同部位T值进行对比,通过灵敏度、特异度、Kappa值、受试者工作特征曲线(ROC)下面积等指标进行评价. 结果 (1)随增龄腰椎、股骨骨质疏松及总的骨密度异常检出率增加,腰椎、股骨骨质疏松检出率80岁以上组分别达16.2％,24.0％.(2) OSTA指数三分类低、中、高危险组分别为:85.0％、11.0％、4.0％.腰椎、髋部骨质疏松检出率OSTA低危险组为2.6％、1.6％,中危险组为10.4％、10.4％;高危险组为29.3％、30.5％.(3)以OSTA≤-1为截断值,T值＜-1筛查灵敏度、特异度分别为28.1％～28.7％、89.0％～92.4％;T值≤2.5时分别为灵敏度51.6％～63.2％,特异度86.7％～86.8％.三分类OSTA与T值一致性Kappa值0.153、0.197,两分类Kappa值0.195、0.243.T值＜-1、≤-2.5腰椎、股骨OSTA指数ROC曲线下面积为0.689～0.823 (P＜0.001),不同年龄组、不同部位OSTA指数ROC曲线下面积为0.639～0.899(P＜0.001). 结论 OSTA指数对50岁以上男性骨质疏松筛查有一定价值;不同年龄组筛查效果不同.
목적 관찰아주골질소송자아평개공구(OSTA)대성도지구중노년남성골질소송、저골량적사사효과평개. 방법 용쌍능X선골밀도의(DXA)측정성도지구40세이상건강남성4042례,측량부위포괄요추(L1～4)、좌고골경、대전자、Wards구、고골간、전관;근거공식계산OSTA득분,안OSTA＞-1、-4＜OSTA≤-1、OSTA≤-4장연구대상분위저위험성、중위험성、고위험성3급혹안OSTA＞-1、OSTA≤-1분위저위험、중고위험량급쌍능X선골밀도의(DXA)측정적불동부위T치진행대비,통과령민도、특이도、Kappa치、수시자공작특정곡선(ROC)하면적등지표진행평개. 결과 (1)수증령요추、고골골질소송급총적골밀도이상검출솔증가,요추、고골골질소송검출솔80세이상조분별체16.2％,24.0％.(2) OSTA지수삼분류저、중、고위험조분별위:85.0％、11.0％、4.0％.요추、관부골질소송검출솔OSTA저위험조위2.6％、1.6％,중위험조위10.4％、10.4％;고위험조위29.3％、30.5％.(3)이OSTA≤-1위절단치,T치＜-1사사령민도、특이도분별위28.1％～28.7％、89.0％～92.4％;T치≤2.5시분별위령민도51.6％～63.2％,특이도86.7％～86.8％.삼분류OSTA여T치일치성Kappa치0.153、0.197,량분류Kappa치0.195、0.243.T치＜-1、≤-2.5요추、고골OSTA지수ROC곡선하면적위0.689～0.823 (P＜0.001),불동년령조、불동부위OSTA지수ROC곡선하면적위0.639～0.899(P＜0.001). 결론 OSTA지수대50세이상남성골질소송사사유일정개치;불동년령조사사효과불동.
Objective To evaluate the screening effect of osteoporosis self-assessment tool for Asians (OSTA) in middle aged and elderly healthy men in Chengdu.Methods A total of 4042 healthy men aged 40 to 106 years received dual energy X-ray absorptiometry (DXA) assay,and OSTA index evaluation.Measurement sites included lumbar spine (L1-4),left femoral neck,trochanter,Ward's area,total hip and femoral shaft.All persons were classified into highosteoporosis-group (OSTA≤-4),mediumosteoporosis-group (-4 ＜ OSTA≤≤-1),low osteoporosis-group (OSTA＞-1),or the low risk-group (OSTA＞-1) and high risk-group (OSTA≤-1) by OSTA scores.T-scores were compared between different measurement sites detected by DXA.The sensitivity,specificity,Kappa value and the area under receiver operating characteristic (ROC) curve (AUC) of OSTA in screening osteoporosis were evaluated.Results The prevalence of osteopenia and osteoporosis in lumbar spine,proximal femur were gradually increased along with aging.The detection rate of osteoporosis in lumbar spine and proximal femur were 16.2％ and 24.0％ respectively in subjects aged over 80 years.OSTA index in low-risk,medium-risk group,high-risk group were 85.0％,11.0％,4.0％ respectively.The detection rate of osteoporosis in lumbar spine and proximal femur were 2.6％ and 1.6％ in low-risk group,10.4％ and 10.4％ in medium-risk group,and 29.3％ and 30.5％ in high-risk group,respectively.Taking OSTA ≤-1 as the cut-off value,the sensitivity and specificity of OSTA in screening osteoporosis in lumbar spine and femur by T-score＜-1 were 28.1％,28.7 ％,89.0％ and 92.4％ respectively,and by T-score≤-2.5 were 51.6％,63.2％,86.7％ and 86.8％ respectively.The consistency of diagnosis result between T-score and OSTA index according to the three versus two risk levels was 0.153 and 0.197 versus 0.195 and 0.243 Kappa value,respectively.The AUC of OSTA index for lumbar spine and femur by T-score＜-1 and T-score≤-2.5 were 0.689 and 0.823,and for different age groups and different measurement sites were 0.639 and 0.899 (all P＜0.001).Conclusions OSTA index has a certain ability in screening osteoporosis in men aged over 50 years.There are different screening results on osteoporosis among the different age groups.