Determination of clinical decision rule for estimation of bone mineral density in women

This study assessed the relative risk factors for osteoporosis in women referring to the Bone Densitometry Center during 2007, with the aim of designing a formula to estimate the severity of osteoporosis.

Data of outpatients (n = 1,047) who visited the Bone Densitometry Center of Chamran Hospital were gathered by administering a questionnaire to subjects before a dual-energy X-ray absorptiometry (DXA) densitometry test of the hip and vertebrae.

Of the 1,047 subjects, 764 (73%) were menopausal. The average (± SD) age and weight were 54.5 ± 10.3 and 69.5 ± 10.8, respectively. The average (± SD) T score of hip and lumbar spine were -1.88 ± 1.08 and -1.04 ± 1.05, respectively. After assessment, the precipitating factors of osteoporosis of the hip were age, menopause, duration of menopause, history of fracture, history and dosage of calcium supplementation, parity and duration of breastfeeding. Protective factors were weight, history of oral contraceptive pill consumption, and exercise, being significant (p < 0.05). Precipitating factors in osteoporosis of vertebrae were age, menopause and duration of menopause, diabetes, history of fracture, history and dosage of calcium supplementation, parity and duration of breastfeeding, with weight as a protective factor (p = <0.05). Using stepwise regression analysis, a minimal mathematical model for prediction of bone density of the hip and lumbar spine was formulated.

Using the mathematical model, along with clinical findings and history, persons at risk of osteoporosis may be identified and early prevention and treatment made possible. Unnecessary expenses of diagnostic procedures for people without the risks of osteoporosis can also be prevented.