Osteoporosis in postmenopausal women (Mexico City): 2. Validation of a predictive clinical index.
OBJECTIVE
To analyze and validate a clinical index (CI) in postmenopausal women that will help to determine the need for bone absorptiometry.


METHODS
1088 postmenopausal women were studied; age, body mass index (BMI) and time since menopause (TM) were analyzed. A score was attributed to each variable (0 points if it did not increase the risk of osteoporosis or 1 point if it increased it): age < or = 48 years = 0 points, >48 years = 1 point; BMI < or = 32 = 1 point or >32 = 0 points for lumbar spine and Ward's triangle (WT); BMI < or = 30 = 1 point or >30 = 0 points for femoral neck (FN); TM < or = 5 years = 0 points or >5 years = 1 point. In all cases, bone absorptiometry (DEXA) was done. Comparison between groups was determined by Student's t test. Regression models were used to establish possible associations between bone absorptiometry and the clinical variables studied. Univariate and multivariate analyses were performed.


RESULTS
The most highly significant differences were observed starting from 2 points in lumbar spine and FN. The most important difference in WT was detected starting from 1 point. In L1-L4 average, a significant correlation was established between the CI and age, TM, and BMI (r = 0.707; P < .001), as well as between the CI and the T score (r = 0.302; P < .001). FN analysis showed a correlation between the CI, the TM, and BMI (r = 0.720; P < .001) and between the CI and T score (r = 0.338; P < .001). WT analysis revealed a correlation between the CI and TM, and BMI (r = 0.698; P < .001) and between the CI and T score (r = 0.324; P < .001).


CONCLUSIONS
It is reasonable to conclude that a score of 2 points in the lumbar spine and FN, and 1 point in WT, suggests the need for bone absorptiometry.
Carranza-Lira
Sebastián
S
Gynecologic Endocrinology Service, Hospital de Ginecobstetricia Luis Castelazo Ayala, IMSS, México DF.
Rosas
Martín
M
Murillo
Alfonso
A
Martínez
Norma
N
Santos
Javier
J
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D005260:Female; D006801:Humans; D015994:Incidence; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D014505:Urban Population