The frequency of osteoporosis and optimal cut-off points for screening fracture risk among women in the north of Jordan : experience at Prince Rashid Bin al-Hassan Hospital

الملخص EN

Objectives : To estimate the frequency of osteoporosis as well as the optimal cut-off points of osteoporosis fracture risk based on bone mineral density T-score of lumbar spine and the total hip region for the women in North of Jordan.

Methods : This is a hospital-based study which was conducted among 394 women with frequent joints pain were seen in the out patient clinic of the physical and medical rehabilitation clinic at Prince Rashid Bin Al-Hassan Military Hospital, North of Jordan, between January and December 2009.

Their age ranged from 32 to 80 years.

Women with secondary osteoporosis were excluded and patients with orthopedic complaints were included in this study.

The bone mineral density (gm / cm2) and T-score were obtained by dual-energy X-ray absorptiometry for the lumbar spine and total hip region, performed in the Department of Nuclear Medicine at King Hussein Medical Center-Amman/Jordan.

We used Statistical Package of Social Science to find the frequency based on WHO definition, the T-score of less than or equal to -2.5 is defined as osteoporosis, a T- score between -1 and -2.5 as osteopenia, and T-score of more than -1 was considered as normal.

The Pearson Correlation statistical method was run between weight, height, Body Mass Index (weight divided by height meter square) and bone mineral density T-score.

Receiver Operating Characteristic Curve analysis classified the 247 women without bone fractures and 147 with bone fractures in order to set the arbitrarily rapid best T-score cut-off values for prediction and screening of fracture risk regardless of the age and race.

Results : The lumbar spine bone mineral density T-score found 260 women (66.0%) to be classified as normal with T-score of -0.7 to -0.4, 12.9% as osteopenic with T score -2.0 to -1.7 and 21.1% as osteoporosis with T-score -3.6 to -3.3.

The total hip bone mineral density T-score was analyzed, 71.8% were normal with T-score -0.6 to -0.3, 17.5% osteopenic with T-score -2.0 to -1.7, and 10.7% as osteoporotic with a T-score of -3.3 to -3.0.

The frequency of osteoporosis increased with increasing age, low weight, and short height (P < 0.05) but did not correlate with Body Mass Index.

The lumbar spine bone mineral T-score ≤ -2.5 was found to be the optimum cut-off value in the prediction of fracture risk (sensitivity 91.2% and specificity 89.9%).

The total hip bone mineral T-score ≤ -2.4 was found to be the optimum cut-off value in the prediction of fracture risk (sensitivity 93.9% and specificity 90.3%).

Conclusions : Early diagnosis of the disease and initiate proper therapy for osteoporosis is available, but prevention is definitely more cost-efficient