Routine Laboratory Markers as Incremental Predictors Beyond OSTA for Dual-Energy X-Ray Absorptiometry-Defined...

Area of Science:

• Endocrinology
• Geriatrics
• Clinical Chemistry

Background:

• Osteoporosis diagnosis relies on bone mineral density (BMD) via DXA scans.
• The Osteoporosis Self-Assessment Tool for Asians (OSTA) is a common screening tool.
• The added value of routine laboratory markers for osteoporosis risk stratification is unclear.

Purpose of the Study:

• To assess if serum uric acid, albumin, alkaline phosphatase (ALP), and inflammatory indices improve osteoporosis prediction beyond OSTA in postmenopausal women.
• To evaluate the incremental predictive value of routine lab tests in a referral setting.

Main Methods:

• Retrospective cross-sectional study of 3504 postmenopausal women referred for DXA.
• Osteoporosis defined by DXA T-score ≤ -2.5.
• Multivariable logistic regression and 10-fold cross-validation were used.

Main Results:

• Osteoporosis was present in 47.4% of women.
• OSTA alone had an AUC of 0.679.
• Adding uric acid, albumin, and ALP modestly increased AUC to 0.695, with minor improvements in calibration and Brier score.

Conclusions:

• Routine laboratory variables offer only modest incremental value for osteoporosis prediction beyond OSTA.
• This model is an exploratory tool for referral pathway prioritization, not a screening or diagnostic surrogate for DXA.