A New Predictive Index for Osteoporosis in Men under 70 Years of Age: An Index to Identify Male Candidates for Osteoporosis Screening by Bone Mineral Density
Background. Bone mineral density (BMD) screening guidelines for osteoporosis in men seem to have remained unclear. We aimed to set up a predictive index for the osteoporosis(PIO) in men under 70 years of age and present the optimal cutoff value of it, so that clinicians might use it to identify male candidates who benefit from taking the BMD screening. Methods. Adult men under 70 years old who met certain criteria were included. With the determined significant predictors for osteoporosis, we created a new index that presumably best predicts the osteoporosis and compared the predictability of it to other variables. Lastly, the optimal cutoff value of the PIO was calculated. Results. A total of 359 men were included. Age, weight, and current smoking status turned out to be significant predictors for osteoporosis. The PIO was as follows: [age(years) + 10 (for current smoker)]/weight(kg). Compared to other variables, the PIO showed the greatest predictive performance with the optimal cutoff point being 0.87 at which sensitivity and specificity were 71.9% and 70.0%, respectively. Conclusion. A new predictive index appeared to predict the presence of osteoporosis fairly well and thus can be used with its cutoff point to identify men under 70 years of age who need BMD screening. 1. Introduction Male osteoporosis has been increasingly recognized as a major global health problem over the last decade. Demographically, its incidence is increasing and expected to keep rising given prolonged life span. Specifically, the prevalence of osteoporosis in Korean men aged 50 years or older was 7.5% according to national health survey data [1]. This figure was higher than that of Caucasians and the increasing trends for osteoporosis seemed to have been on steady rise since early twenty-first century. The clinical importance of osteoporosis comes from the fact that fractures associated with osteoporosis show high morbidity and mortality in men compared with women [2]. In this regard, early detection of men with osteoporosis is determined by bone mineral density (BMD), so that they may benefit from early treatment that seems important strategy. Currently, BMD is still considered a single important predictor of fracture risk [3–5] despite a wide use of FRAX, a powerful tool to predict 10-year fracture probability that also includes BMD as one of data to calculate the risk [6]. In this sense, there is no doubt that BMD measurement has significant screening value and now the point is how to identify men who are likely to have osteoporosis and should, therefore, undergo BMD
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