Predictive values of Osteoporosis Self-Assessment Screening Tool for Asians(OSTA) score and body mass index(BMI) in patients with lumbar degenerative disease and osteoporosis

English Keywords:Lumbar degenerative disease  Osteoporosis  OSTA score  BMI

English Abstract:

  【Abstract】 Objectives: To analyze the epidemiological characteristics of osteoporosis and osteopenia in patients with lumbar degenerative diseases, and to evaluate the predictive values of Osteoporosis Self-Assessment Screening Tool for Asians(OSTA) score and body mass index(BMI) for osteoporosis in this population. Methods: The clinical data of 432 patients with lumbar degenerative diseases admitted to the Department of Orthopedics of Huashan Hospital from January 2020 to December 2022 were analyzed retrospectively, including 120 males with an average age of 72.0±5.4 years and 312 females with an average age of 67.2±31.1 years old. All the patients underwent dual-energy X-ray absorptiometry(DXA) examination and lumbar CT scan in our hospital within 3 months before admission or after admission. OSTA score and BMI were calculated based on patient′s age, height, and weight. Chi-square test was used to compare the incidence rates of osteoporosis and osteopenia in patients of different ages and genders. Receiver operating characteristics(ROC) curve was constructed and the area under the curve(AUC) was calculated. After determining the optimal cutoff value, the sensitivity, specificity, positive predictive value, and negative predictive value were calculated at this cutoff value. Results: According to the DXA examination results, the prevalence rates of osteoporosis in male patients over 65 years old and female patients over 50 years old were 14.17% and 37.50% respectively, and the prevalence rates of osteopenia were 52.50% and 48.08% respectively. The diagnostic compliance rate of lumbar and total hip DXA was 60.2%. In female patients of different age groups, the prevalence of osteoporosis or osteopenia increased in older age group, but the difference was not statistically significant. The prevalence of osteoporosis in women over 65 years old was greater than in men over 65 years old(P=0.000). Among the 297 patients diagnosed with osteopenia or normal bone mass by DXA, 11.78% of them met the diagnostic criteria for osteoporosis in CT examination. The sensitivity of the OSTA score in predicting osteoporosis in male and female patients with lumbar degenerative disease was both 55.56%, and the negative predictive values were 89.04% and 79.19%, respectively, indicating limited predictive value for osteoporosis. The AUC of BMI in male and female patients with lumbar degenerative disease were 0.672 and 0.668 respectively, with sensitivities of 77.78% and 73.50%, and the negative predictive values of 93.10% and 76.69% respectively. The BMI had certain predictive value for osteoporosis. After correcting the diagnosis of osteoporosis with lumbar CT examination, the screening efficacy of OSTA score and BMI improved in both male and female patient populations. Conclusions: The epidemiological characteristics of osteoporosis in patients with lumbar degenerative diseases are high prevalence and low treatment rate. The prevalence of osteoporosis in women is significantly higher than that in men. The OSTA score has limited value in predicting osteoporosis, while BMI can be used as one of the initial screening tools for osteoporosis in this population.