Original ArticlesA simple system to determine who needs osteoporosis screening
Section snippets
Materials and methods
The study was performed by interviewing 1346 menopausal women consecutively during a 2-year period with a questionnaire developed by the senior author. The women presented for osteoporosis evaluation and had a dual-energy x-ray absorptiometry scan of three sites. The questionnaire was administered in person before or during the scan, which was done with a Hologic QDR 1500 densitometer (Hologic Inc., Waltham, MA). The sites evaluated were lumbar spine (L1–4) in the anteroposterior position,
Results
The population studied consisted of 1346 menopausal women. They were all white and had been referred by their private physician for a scan for osteoporosis evaluation. All women were having their first scan. None were taking bisphosphonate or calcitonin. The mean age of the patients was 62.2 years (standard deviation [SD] 10.3 years), mean weight was 149.6 pounds (SD 32.2 pounds), and mean years from menopause was 16.2 (SD 11.0 years).
Osteoporosis was absent at all three sites in 873 women
Discussion
Our results suggest that the risk factors usually used to determine who might have osteoporosis and therefore benefit from screening might not be reliable. We demonstrated that the strongest associations with osteoporosis occur with increasing age, decreasing weight, and never having used oral estrogen therapy for 6 months or longer. The beneficial effects of estrogen in the form of oral contraceptives on bone mineral density have been reported previously.8, 9
Several impediments to screening
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Osteoporosis Risk Calculators
2017, Journal of Clinical DensitometryCitation Excerpt :Study variables included past or current use of steroids, thyroid replacement, heparin, oral contraceptives, estrogen replacement therapy, alcohol (none, 5.0; mild, 5.1; moderate, 5.2; and excessive, 5.3), caffeine intake (0–3), exercise (0–3), dietary calcium intake (500 mg, 5.0; 500–1000 mg, 5.1; 1000–1500 mg, 5.2; and 1500 mg, 5.3), calcium supplementation (0–3), past or present smoking, presence or absence of the uterus or ovaries, and family history of osteoporosis. Smoking history, oral contraceptive use, and estrogen replacement therapy were considered positive if usage was 6 mo or longer (25). Multivariate logistic regression, performed to determine which independent variables were significant predictors, revealed age and years of menopause to be positive predictors and weight to be a negative predictor for osteoporosis at any of the 3 sites (all p < 0.001).
Risk indices and osteoporosis screening: Scope and limits
2002, Mayo Clinic Proceedings