Validation of osteoporosis risk assessment tools in middle-aged Thai women.
OBJECTIVE
To validate osteoporosis risk assessment tools in middle-aged Thai women.


METHODS
A total of 1038 women who had bone mineral density (BMD) measurements using dual-energy X-ray absorptiometry were reviewed. Clinical data were used to validate the diagnostic test performance of various osteoporosis risk assessment tools, including ABONE, FRAX®, ORAI, OSIRIS, SCORE, SOFSURF, and OSTA. The following parameters were evaluated: sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy; those with 95% confidence interval (CI) of the receiver operator characteristics area under the curve (ROC-AUC) > 0.5 were considered statistically significant.


RESULTS
The subjects had a mean age of 53.01 ± 6.20 years and body mass index (BMI) of 23.98 ± 3.38 kg/m2. Among the osteoporosis risk assessment tools being evaluated, the tools that had ROC-AUC >0.8 and 95% CI >0.5, and could predict osteoporosis at the femoral neck with high specificity of >75% and NPV of >90%, were FRAX®without BMD (ROC-AUC 0.83; 95% CI 0.73-0.93; specificity 99.90; NPV 98.89), SCORE (ROC-AUC 0.86; 95% CI 0.78-0.94; specificity 98.79; NPV 98.99), and OSTA (ROC-AUC 0.86; 95% CI 0.79-0.94; specificity 75.03; NPV 99.73).


CONCLUSIONS
The prevalence of osteoporosis in the middle-aged Thai women attending Siriraj Menopause Clinic is 7.3% at the lumbar spine and/or femoral neck. FRAX®without BMD, SCORE, and OSTA have appropriate validity as tools for ruling out osteoporosis in these women.
a Gynecologic Endocrinology Unit, Division of Reproductive Medicine, Department of Obstetrics and Gynecology , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand.
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Indhavivadhana
a Gynecologic Endocrinology Unit, Division of Reproductive Medicine, Department of Obstetrics and Gynecology , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand.
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Rattanachaiyanont
a Gynecologic Endocrinology Unit, Division of Reproductive Medicine, Department of Obstetrics and Gynecology , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand.
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Angsuwathana
a Gynecologic Endocrinology Unit, Division of Reproductive Medicine, Department of Obstetrics and Gynecology , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand.
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Techatraisak
a Gynecologic Endocrinology Unit, Division of Reproductive Medicine, Department of Obstetrics and Gynecology , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand.
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Tanmahasamut
a Gynecologic Endocrinology Unit, Division of Reproductive Medicine, Department of Obstetrics and Gynecology , Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand.
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Leerasiri
D015502:Absorptiometry, Photon; D019540:Area Under Curve; D015992:Body Mass Index; D015519:Bone Density; D005260:Female; D005272:Femur Neck; D006801:Humans; D008159:Lumbar Vertebrae; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000453:epidemiology*; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D013785:Thailand / Q000453:epidemiology
Middle-aged women; osteoporosis risk assessment tools; validation