The relationship between quantitative ultrasound and osteoporosis self-assessment tool for Asians (OSTA) score and non-vertebral fracture in postmenopausal Chinese women

OBJECTIVE: To assess a simple and non-invasive scoring system, osteoporosis self-assessment tool for Asians (OSTA) and quantitative ultrasound (QUS) measurement to identify Chinese postmenopausal women with non-vertebral fracture. METHODS: Data came from 513 healthy women. Speed of sound (SOS) of the radius, phalanx and tibia was assessed using the instrument of Omniscience (Sunlight Ltd. Israel). Body height and weight were measured. Body mass index and OSTA were calculated. Self-reported fractures were identified using a structured questionnaire. RESULTS: SOS of radius was significantly lower in women with non-vertebral fracture than those without. SOS of phalanx was significantly lower in women with a history of postmenopausal non-vertebral fracture than those without. Using cut-offs of OSTA -4 and -1 to categorize osteoporosis risk, SOS of radius, phalanx and tibia decreased with increasing risk, while the prevalence of non-vertebral fracture increased. OSTA values of <or= -1 had a sensitivity of 75% and specificity of 48%, with an area under curve (AUC) of 0.64 to discriminate women with and without a history of postmenopausal non-vertebral fracture. The optimal cut-off T-score of -1.95 for phalanx yielded sensitivity and specificity of 81% and 40%, respectively, with an AUC of 0.66. Combination of OSTA and phalanx QUS gave a sensitivity of 83% and specificity of 84% to identify postmenopausal women with a history of postmenopausal non-vertebral fracture, and an AUC of 0.64. CONCLUSIONS: It is concluded that OSTA and phalanx QUS are effective measures for identifying postmenopausal women at increased risk of non-vertebral fracture. The use of the both parameters could facilitate appropriate and more cost-effective use of bone densitometry to prevent osteoporotic fractures in developing countries.