ASSESSMENT OF OSTEOPOROSIS IN TYPE 2 DIABETES PATIENTS BY OSTA AND FRAX
DOI:
https://doi.org/10.70520/kjms.v18i2.687Keywords:
OSTA, FRAX, Osteoporosis, DEXA, PakistanAbstract
Objective: We investigated the accuracy of OSTA and FRAX screening tools (without BMD measurements) in identifying osteoporosis among Type 2 diabetes patients.
Methodology: This study was performed at the Department of Diabetes and Endocrinology, Lady Reading Hospital Peshawar, and included 174 T2DM patients aged 45-65 of either sex who had “Dual-Energy X-ray absorptiometry” (DEXA) scan.
Results: Osteoporosis was detected in 28.6% of lumbar spine measurements and 22.3% of femoral neck measurements. Researchers identified a strong negative correlation between bone mineral density (BMD) and FRAX score for both “Major Osteoporotic Fractures” (MOF) and “Hip Fractures” (HF) at both skeletal sites examined (p < 0.001). The OSTA score demonstrated a positive correlation with BMD at both the lumbar spine (p = 0.002) and femoral neck (p < 0.001). When assessing predictive performance, area under the curve (AUC) values were 0.83 (95% CI, 0.7-0.9) for FRAX-MOF, 0.87 (95% CI, 0.8-0.9) for FRAX-HF, and 0.61 (95% CI, 0.5-0.7) for OSTA.
Conclusion: Both OSTA and FRAX effectively detect primary osteoporosis, with FRAX showing slightly superior performance in type 2 diabetes patients. These tools help identify high-risk T2DM patients and provide practical solutions for appropriately using DEXA scans, especially in areas without DEXA availability
References
1. Clynes MA, Harvey NC, Curtis EM, Fuggle NR, Dennison EM, Cooper C. The epidemiology of osteoporosis. British medical bulletin. 2020;133(1):105-17.
2. Sangondimath G, Sen RK. DEXA and Imaging in Osteoporosis. Indian Journal of Orthopaedics. 2023;57(Suppl 1):82-93.
3. Niaz T, Riaz U, Zaheer M, Shahzadi T, Ayub R, Umar B. Prevalence of Osteoporosis Following Menopause: Osteoporosis Following Menopause. Pakistan BioMedical Journal. 2022:150-3.
4. Si Y, Wang C, Guo Y, Yin H, Yong M. Prevalence of osteoporosis in patients with type 2 diabetes mellitus in the Chinese mainland: A protocol of systematic review and meta-analysis. Medicine. 2020;99(16):e19762.
5. Zhou Y, Yu Y, Zhuang Z, Shi P, Wan Y, Ni Q. Global, Regional, and National Burdens of Type 1 and Type 2 Diabetes in Adolescents and Young Adults Aged from 10 to 24 Years from 1992 to 2021: A Trend Analysis Based on the Global Burden of Disease Study 2021. Available at SSRN 4888103.
6. Pan Y, Xu J. Association between muscle mass, bone mineral density and osteoporosis in type 2 diabetes. Journal of diabetes investigation. 2022;13(2):351-8.
7. Sheng Y-H, Wu T-Y, Liaw C-K, Hsiao S-H, Kuo K-L, Tsai C-Y. Real world fracture prediction of fracture risk assessment tool (FRAX), osteoporosis self-assessment tool for Asians (OSTA) and one-minute osteoporosis risk test: An 11-year longitudinal study. Bone Reports. 2024;20:101742.
8. Khan S, Kausar MF, Waheed A, Raza T, Qadir A, Jamil N. Impact of Menopausal Hormonal Changes on Bone Health, Orthopedic, Gynecological, and Medical Perspectives. A Cross-Sectional Clinical Study. Pakistan Journal of Medical & Health Sciences. 2023;17(02):917-.
9. e Raana G, Malik A, Khurshid R. Risk of osteoporosis in first degree relatives of patients with diabetes mellitus: a study of bone mineral ions. Pakistan Journal of Physiology. 2011;7(1):20-2.
10. Willers C, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M, et al. Osteoporosis in Europe: a compendium of country-specific reports. Archives of osteoporosis. 2022;17(1):23.
11. Thomson M, Scott A, Trost S, Lake J, Lim N. Low screening rates and high prevalence of osteoporosis in cirrhosis: a real?world retrospective analysis. Alimentary Pharmacology & Therapeutics. 2024;59(4):535-46.
12. Ghalenavi E, Mirfeizi Z, Hashemzadeh K, Sahebari M, Jokar MH, Samadi S. Diagnostic value of radiographic singh index compared to dual-energy X-ray absorptiometry scan in diagnosing osteoporosis: a systematic review. Archives of Bone and Joint Surgery. 2024;12(1):1.
13. Chavda S, Chavda B, Dube R. Osteoporosis screening and fracture risk assessment tool: its scope and role in general clinical practice. Cureus. 2022;14(7).
