Predicting the risk of osteopenia for women aged 40–55 years

Background/purpose Osteoporosis has been linked to an increased fracture risk and subsequent mortality in the later life. Previous prediction models have focused on osteoporosis in postmenopausal women; however, a prediction tool for osteopenia is needed. Our objective was to establish a prediction model for osteopenia risk in women aged 40–55 years. Methods This was a cross-sectional study. A total of 1350 Taiwanese women aged 40–55 years were recruited from a health checkup center from 2009 to 2010. The main outcome measure was osteopenia (−1 ≥ bone mineral density T-score > −2.5). Results The Osteoporosis Preclinical Assessment Tool (OPAT) developed in this study was based on variables with biological importance to osteopenia and variables that remained significant (p < 0.05) in the multivariable analysis, which include age, menopausal status, weight, and alkaline phosphatase level. The OPAT has a total score that ranges from 0 to 7, and categorizes women into high-, moderate-, and low-risk groups. The predictive ability of the OPAT (area under the receiver operating characteristic curve = 0.77) was significantly better than that of the Osteoporosis Self-assessment Tool for Asians (area under the receiver operating characteristic curve = 0.69). The inclusion of serum total alkaline phosphatase level in the model, which is easy to obtain from routine health checkups, significantly enhanced the sensitivity (McNemar test, p = 0.004) for detecting osteopenia in women aged 40–55 years. Conclusion Our findings provide an important tool for identifying women at risk of osteoporosis at the preclinical phase.