Aged ; Asian Continental Ancestry Group/statistics & numerical data* ; Bone Density ; Female ; Humans ; Male ; Middle Aged ; Models, Biological* ; Nutrition Surveys ; Osteoporosis/diagnosis* ; Osteoporosis/ethnology ; Predictive Value of Tests ; Prevalence ; ROC Curve ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment/methods* ; Sensitivity and Specificity ; Surveys and Questionnaires/standards*
Keywords
Korea ; Osteoporosis ; men ; risk assessment
Abstract
PURPOSE: The aim of the present study was to develop an osteoporosis risk-assessment model to identify high-risk individuals among Korean men.
MATERIALS AND METHODS: The study used data from 1340 and 1110 men ≥50 years who participated in the 2009 and 2010 Korean National Health and Nutrition Examination Survey, respectively, for development and validation of an osteoporosis risk-assessment model. Osteoporosis was defined as T score ≤-2.5 at either the femoral neck or lumbar spine. Performance of the candidate models and the Osteoporosis Self-assessment Tool for Asian (OSTA) was compared with sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). A net reclassification improvement was further calculated to compare the developed Korean Osteoporosis Risk-Assessment Model for Men (KORAM-M) with OSTA.
RESULTS: In the development dataset, the prevalence of osteoporosis was 8.1%. KORAM-M, consisting of age and body weight, had a sensitivity of 90.8%, a specificity of 42.4%, and an AUC of 0.666 with a cut-off score of -9. In the validation dataset, similar results were shown: sensitivity 87.9%, specificity 39.7%, and AUC 0.638. Additionally, risk categorization with KORAM-M showed improved reclassification over that of OSTA up to 22.8%.
CONCLUSION: KORAM-M can be simply used as a pre-screening tool to identify candidates for dual energy X-ray absorptiometry tests.