【摘要】 目的探讨亚洲妇女骨质疏松自我评价工具(OSTA)应用于我国大陆地区绝经后妇女的筛选效果,为促进我国骨质疏松筛检工具的研究与建立提供参考依据。方法利用我国"骨密度参考数据库"中绝经后妇女股骨颈骨密度的数据,根据OSTA计算公式得到每个被测者的OSTA得分,依据其筛选临界值将所有对象划分为3个危险性等级或有、无骨质疏松危险性两类,并与双能X线骨密度仪(DXA)测定的股骨颈骨密度所得T-score进行对比分析,通过灵敏度、特异度、Kappa值、ROC曲线下面积等指标进行评价。结果按照三级筛选界值进行骨质疏松危险性判定,Kappa=0.357(P<0.001);按两类界值,Kappa=0.418(P<0.001),灵敏度为73.8%,特异度为68.2%,阳性预测值为76.1%,阴性预测值为65.4%。结果均表明OSTA与T-score的分类一致性较差。调整临界值后,该分类一致性没有得到改善。经ROC分析,曲线下面积为0.789,表明OSTA具有中等应用价值。结论OSTA在我国的临床适用性不理想。因此,探索适用于我国大陆地区绝经后妇女的骨质疏松筛检工具仍具有重要的现实意义。更多还原

【Abstract】 Objective To evaluate the screening effect of OSTA in Chinese post-menopausal women, to provide suggestions for the further development of OP screening in China’s mainland. Methods With the data from Chinese Database of Bone Mineral Density of Chinese women aged 50 years old and above, each subject was calculated a OSTA score by the formula of OSTA and classified into three risk levels (the normal, the osteopenia and the osteoporosis) or two groups (the low and the high risk) by the original cutoffs, and compared with results by T-score. A series of screening indexes, such as sensitivity, specificity, kappa value and ROC etc., were employed to compare and analyze the diagnosis results of OSTA with T-score from the femoral neck bone density. Results According to the 3 levels by original cutoffs, the Kappa value was 0.357 (P<0.001) and according to the two groups levels, Kappa=0.418 (P<0.001), sensitivity was 73.8%, specificity was 68.2%, positive predictive value was 76.1%, and negative predictive value was 65.4%. All of those indicators showed that the consistency of the diagnosis result between T-score and OSTA was not satisfied. After adjusting the cutoffs, the consistency had not significantly been improved. The area under ROC curve was 0.789 which indicated that the value for screening of OSTA was middle. Conclusion OSTA was not an ideal tool to screen for osteoporosis risk in Chinese post-menopausal women. So it’s very important to explore more suitable screening tool.更多还原