Proundly Supported by
Pfizer Foundation
    Home | Current Issue | Past Issue | Board | Instruction | Contact


Validation of the OSTA Index for Discriminating between High and Low Probability of Femoral Neck and Lumbar Spine Osteoporosis among Thai Postmenopausal Women

1286


Sarayut Geater MD*,
Rattana Leelawattana MD*, Alan Geater PhD**

* Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University
** Epidemiology Unit, Faculty of Medicine, Prince of Songkla University

Abstract


Rationale : Bone mineral density (BMD) measurement of postmenopausal women is needed to diagnose osteoporosis. This is an expensive procedure and available in only a few hospitals in Thailand. The Osteoporosis Self-Assessment Tool for Asians (OSTA) index, based on age and weight, has been developed for screening of postmenopausal Asian women to identify women for whom there is little advantage in undergoing bone densitometry. This index was developed for prediction of neck of the femur osteoporosis and did not include spinal osteoporosis, which is also common. Furthermore, the index was based on data from a sample of mainly ethnic Chinese. There is evidence that the BMD of Thai women is significantly higher for the same age and weight than that of women of several other Asian ethnics, thus there is a need to validate the appropriateness of the OSTA index for both femur and spinal osteoporosis among the Thai population.
Objective : To determine the properties of the OSTA index as a screening tool among postmenopausal women in southern Thailand.
Patients : Three-hundred-and-eighty-eight postmenopausal women, with no history of disease or use of drugs associated with secondary osteoporosis and no history of treatment for osteoporosis, attending the postmenopausal clinic or internal medicine out-patient department of Songklanagarind Hospital, a teaching hospital in southern Thailand, between November 2000 and April 2002.
Method : BMD t-scores of the neck of the femur and lumbar spine were collected retrospectively and a diagnosis of osteoporosis made according to WHO criteria. Sensitivity and specificity and their 95% confidence limits were calculated for the dichotomized OSTA index.
Results : Thirty-one percent of the women were detected as having osteoporosis, comprising neck of the femur (12 percent) and lumbar spine (31 percent). Twenty nine women (7.5 percent) had evidence of spinal fracture. The OSTA index at the standard cut-point of < -1 had a sensitivity and specificity of 0.93 (95% CI: 0.82 - 0.99) and 0.61 (95% CI: 0.56-0.66) respectively for neck of the femur but only 0.80 (95% CI: 0.72-0.87) and 0.70 (95% CI: 0.64-0.75) respectively for lumbar spine. Raising the cut-point to < 0 reduced the high false negative rate (0.20) in prediction of lumbar spine osteoporosis to 0.07 (95% CI: 0.03-0.13) and identified 27 percent (95% CI: 23-32 percent) of all women at low risk of osteoporosis at either site. These women may not need to undergo BMD measurement.
Conclusion : The standard cut-point of the OSTA index could identify most Thai postmenopausal women with osteoporosis of the neck of the femur. However, to improve the sensitivity of detection of osteoporosis of the lumbar spine, the cut-point of < 0 may be more appropriate.

Keyword : OSTA index, Thai postmenopausal women, Femoral neck, Lumbar spine, Osteoporosis



Download Full Paper
  Vol87_No11_1286.pdf  [ 124.09 Kb]

Home | Current Issue | Past Issue | Board | Instruction | Contact

© Copyright The Medical Association of Thailand. All Rights Reserved.2001-2002
Acquista Cialis generico 5 mg Effetti collaterali del Cialis 5 mg Acquista Cialis 20mg online Prezzo di Cialis originale in Svizzera Acquista Viagra in Svizzera senza prescrizione Dove comprare Cialis 10mg Viagra in farmacia online effetti collaterali Costo di Cialis 5mg Opiniones de Reduslim Acquista Spedra Avanafil senza prescrizione Acquista Viagra in Svizzera senza prescrizione Comprar Cialis original Comprar Viagra Contrareembolso Cialis 5mg Viagra sin receta Cialis 5 mg efectos secundarios graves Reduslim precio Trastorno de la ereccin venta de tadalafilo avanafil prezzo cialis 20 mg prezzo cialis effetti benefici cialis 10 mg Reduslim Kaufen pulse crypto price prediction avanafil 100 mg prezzo buy cialis or generic tadalafil 9 http://diplomsagroups.com https://gosznac-diploma.com/ http://sreestrom.ru/ http://originality-diplomy.com https://russian-diplom.com 9 http://russdiplomiki.com https://diplomansy.com 11 https://diploms-asx.com http://diplomrussian.com 11 https://rudiplomisty24.com/ https://russiany-diploman.com/ https://land-diplom.com/ 11 https://kyc-diplom.com http://diploms-service.com https://originaly-dokuments.com https://diplomy-grup24.com/ http://aurus-diploms.com/kupit-diplom-stroitelya.html 9 https://diplomansy.com/kupit-diplom-s-reestrom http://diploms-service.com/diplomy-po-gorodam/novosibirsk 11 http://diplomyland.com/ https://premialnie-diplomansy.com https://diplomiki.com
https://aurus-diplomany.com
https://russiany-diplomana.com
https://originality-diplomik.com
https://lands-diplomy.com
https://okdiplom.com/
https://nsk-diplom.com/
https://ry-diplom.com/
https://diploms-vuza.com/
https://diplom-bez-problem.com/
https://kazdiplomas.com/
https://diplomoz-197.com/
https://kupit-diplomyz24.com/
https://prodiplome.com/
https://diplom5.com/
https://10000diplomov.ru/
https://1magistr.ru/
https://diplom-insti.ru/
https://kdiplom.ru/
https://diplom45.ru/
https://diplom-zakaz.ru/
https://peoplediplom.ru/
https://diplom-profi.ru/
https://bisness-diplom.ru/
https://kupite-diplom0024.ru/
11
11
11
https://diploman-asx.com
11
https://rudiplomirovany.com
https://premialnie-diploms.com
https://diplomans-doc.com
https://russiany-diplom.com
https://diplomy-gruppa.com
https://rudiplomis.com
https://rudiplomisty.com/
https://lands-diploms.com
https://originality-diploman.com
https://originality-diplomx24.com
https://originality-diploms24.com
https://originality-diploma24.com
https://originality-diploman24.com
https://originality-diplomans24.com
https://originality-diplomik24.com
https://originality-diplomix24.com
https://originality-diplomas24.com
9
https://originality-diplomiks24.com
https://originality-diplomiki24.com
https://ru-diplomirovan.com
https://ru-diplomirovany.com
www.ru-diplomirovanay.com
https://ru-diplomirovannie.com
rudiplomir.com
rudiplomirs.com
www.rudiplomira.com
rudiplomiry.com
https://rudiplomiru.com
ab-diplom24.ru
www.ab-diplom24.ru
http://www.24diplom07.ru
http://landik-attestats365.com
http://study-diploms.com}
9
11
9
http://diplomsagroups.com/kupit-diplom-o-srednem-obrazovanii/diplom-o-srednem-i-srednem-specialnom-obrazovanii.html
11
http://diplomsagroups.com/kupit-attestat-shkoly.html
https://premialnie-diplomansy.com/----/
https://premialnie-diplomansy.com/----/
https://premialnie-diplomansy.com/--/
https://russiany-diplomans.com/attestat-9-klassov
https://russiany-diplomans.com/srednee-spetsialnoe-obrazovanie
https://russiany-diplomans.com/kupit-diplom-kolledzha
https://russiany-diplomans.com/diplom-magistra
http://lands-diploms.com/ http://lands-diploms.com/specialnosti/yurist.html http://lands-diploms.com/goroda/krasnodar.html http://lands-diploms.com/goroda/omsk.html http://lands-diploms.com/goroda/chelyabinsk.html
http://aurus-diploms.com/attestat-9-klass.html http://aurus-diploms.com/obrazovanie/kupit-diplom-s-zaneseniem-v-reestr.html http://aurus-diploms.com/diplom-magistra.html http://aurus-diploms.com/geography/kupit-diplom-v-samare.html
http://radiploma.com/kupit-diplom-s-reestrom http://radiploma.com/kupit-diplomy-tehnikuma-kolledzha http://radiploma.com/kupit-diplomy-o-srednem-tehnicheskom-obrazovanii http://radiploma.com/kupit-diplom-kosmetologa
https://aurus-diplomans.com http://www.diplomas-asx.com https://diplomana-asx.com www.rusd-diplom.com https://rusd-diploms.com https://aurus-diplomany.com https://aurus-diplomik.com www.aurus-diplomas.com https://diplomans-asx.com diplomany-asx.com http://www.diplomys-asx.com https://diploman-servise.com http://www.radiploms.com http://www.radiplom.com radiplomy.com radiploma.com rudiplomisty24.com/--- http://www.rudiplomisty24.com/--- www.rudiplomisty24.com/--- rudiplomisty24.com/--
www.originality-diploman.com/----- originality-diploman.com/- originality-diploman.com/- www.originality-diploman.com/--
www.gosznac-diplomy.com/kupit-diplom-o-srednem-texnicheskom-obrazovanii www.gosznac-diplomy.com/diplom-spetcialista https://gosznac-diplomy.com/kupit-diplom-v-cheliabinske
diploman-asx.com/kupit-diplom-moskva https://diploman-asx.com/otzyvy http://www.diploman-asx.com/kupit-diplom-bakalavra-ili-specialista https://diploman-asx.com/kupit-diplom-specialista
11
http://www.diplom-belarus.com
diplomi-price.com
edu-digest.ru
http://proobzh.ru
http://www.edu-nt.ru/
http://www.student-madi.ru
http://dof-edu.ru
9
http://proobzh.ru
www.krsk-school47.ru http://www.russdiplomik.com/kupit-diplom-v-moskve.html russdiplomik.com/diplom-farmaczevta.html russdiplomik.com/diplom-s-reestrom-o-vyisshem-obrazovanii.html http://www.russdiplomik.com/kupit-diplom-v-novosibirske.html
http://www.russdiplomik.com/diplom-czena.html www.russdiplomik.com/diplom-farmaczevta.html russdiplomik.com/kupit-diplom-sankt-peterburg.html russdiplomik.com/kupit-diplom-v-ekaterinburge.html https://russiany-diplomans.com/diplom-o-srednem-obrazovanii http://www.russiany-diplomans.com/kupit-diplom-vracha www.russiany-diplomans.com/kupit-diplom-ekaterinburg http://www.russiany-diplomans.com/kupit-diplom-pskov https://arena-diplom24.com/attestaty https://arena-diplom24.com/diplomy-po-spetsialnosti/diplom-yurista https://ryazan.arena-diplom24.com/ http://www.novorossijsk.arena-diplom24.com/ www.diploms-goznak.com/attestat-vechernej-shkoly http://diploms-goznak.com/kupit-diplom-v-dnepropetrovske http://www.diploms-goznak.com/kupit-diplom-v-zhitomire http://diploms-goznak.com/kupit-diplom-v-zaporozhe - www.diploms-goznak.com/kupit-diplom-v-odesse diploms-goznak.com/vrach www.diploms-goznak.com/diplom-uchilishcha www.diploms-goznak.com/diplom-starogo-obraztsa http://www.diploms-goznak.com/diplom-tekhnikuma-kolledzha diploms-goznak.com/farmatsevt diploms-goznak.com/yurist http://diploms-goznak.com/meditsinskij-diplom diploms-goznak.com/svidetelstvo-o-rozhdenii
https://diplomy-servise.com
diploman-dok.com
diploman-doks.com
diploman-doky.com
www.diploman-doku.com http://education-ua.com/kupit-legalnyij-diplom-v-ukraine.html
www.education-ua.com/attestat-diplom.html
education-ua.com/zaporozhe.html
education-ua.com/kieve.html
http://education-ua.com/odesse.html
http://education-ua.com/summah.html
9
http://education-ua.com/ternopole.html
education-ua.com/diplom-o-mediczinskom-obrazovanii.html
http://www.education-ua.com/diplom-vyisshee.html
http://education-ua.com/kupit-nastoyashhij-diplom-goznak.html
http://www.education-ua.com/
education-ua.com/diplom-texnikuma-kolledzha.html
education-ua.com/diplom-magistra-ukrainskogo-vuza.html
http://www.education-ua.com/diplom-o-mediczinskom-obrazovanii.html
http://www.education-ua.com/diplom-medsestry.html
www.education-ua.com/diplom-nedorogo.html
http://education-ua.com/kupit-diplom-novogo-obrazca.html
www.education-ua.com/otzivi-pogelania.html
www.education-ua.com/diplom-vyisshee.html
http://education-ua.com/diplom-uchilishha.html
http://education-ua.com/diplom-s-registracziej.html
http://www.education-ua.com/kupit-diplom-s-provodkoj-v-ukraine.html
http://www.education-ua.com/diplom-specialista-ukrainskogo-vuza.html
http://www.education-ua.com/diplom-uchilishha.html
http://www.education-ua.com/kupit-diplom-sssr-na-nastoyashhem-blanke.html
http://education-ua.com/svidetelstvo-o-rozhdenii.html
11
http://education-ua.com/svidetelstvo-o-smerti.html
education-ua.com/svidetelstvo-o-brake.html
www.education-ua.com/svidetelstvo-o-razvode.html http://rudiplomisty24.com/-11- https://diplomy-servise.com http://dipplomy.com www.egpu.ru http://vina-net.ru/ cursovik.ru www.spravkipiter.ru alcoself.ru www.school625.ru www.moek-college.ru www.mmcmedclinic.ru www.intimvisit.ru http://med-pravo.ru/ http://moskva-medcentr.ru/ intim-72.ru razigrushki.ru www.dgartschool.ru www.ftbteam.ru http://sb26.ru/ http://www.originaly-dokuments.com/attestaty/attestat-za-9-klass https://originaly-dokuments.com/diplom-o-srednem-spetsialnom-obrazovanii https://originaly-dokuments.com/gorod/nizhnij-tagil https://originaly-dokuments.com/gorod/vologda www.originaly-dokuments.com/gorod/saratov https://originaly-dokuments.com/spetsialnosti/yurist originaly-dokuments.com/spetsialnosti/povar www.originaly-dokuments.com/gorod/krasnodar originaly-dokuments.com/attestaty/attestat-za-11-klass http://www.originaly-dokuments.com/gorod/ekaterinburg www.originaly-dokuments.com/attestaty https://originaly-dokuments.com/spetsialnosti/bukhgalter www.originaly-dokuments.com/gorod/omsk originaly-dokuments.com/gorod/novosibirsk www.originaly-dokuments.com/gorod/sankt-peterburg originaly-dokuments.com/gorod/chelyabinsk www.originaly-dokuments.com/gorod/orjol originaly-dokuments.com/diplom-o-vysshem-obrazovanii/diplom-bakalavra originaly-dokuments.com/diplom-o-vysshem-obrazovanii/diplom-magistra www.originaly-dokuments.com/spetsialnosti/menedzher https://originaly-dokuments.com/diplom-o-srednem-spetsialnom-obrazovanii/diplom-kolledzha https://originaly-dokuments.com/diplom-o-srednem-spetsialnom-obrazovanii
- - - -- - - premialnie-diplomansy.com https://premialnie-diplomansy.com/--/ www.premialnie-diplomansy.com www.originality-diploman.com originality-diploman.com https://originality-diploman.com/-- originality-diploman.com https://originality-diploman.com/-- https://originality-diploman.com/---- www.originality-diploman.com http://https://originality-diploman.com/-- premialnie-diplomansy.com originality-diploman.com www.premialnie-diplomansy.com premialnie-diplomansy.com https://premialnie-diplomansy.com/--/ https://premialnie-diplomansy.com/--/ www.premialnie-diplomansy.com www.premialnie-diplomansy.com http://https://originality-diploman.com/--
9
www.gosznac-diplomy.com http://https://gosznac-diplomy.com/kupit-diplom-vuza-rossii http://https://gosznac-diplomy.com/diplom-sredne-spetcialnoe-obrazovanie http://https://gosznac-diplomy.com/kupit-diplom-v-moskve gosznac-diplomy.com gosznac-diplomy.com https://gosznac-diplomy.com/svidetelstvo-o-rozhdenii http://https://gosznac-diplomy.com/diplom-feldshera gosznac-diplomy.com https://gosznac-diplomy.com/diplom-stroitelya
9 9 11
originality-diplomans.com
rudiplomis24.com
www.diploma-asx.com
https://gosznac-diplom.com/ diploman-doci.com
https://originality-diplomans.com/
www.rudiplomis24.com
https://lands-diplom.com/
https://gosznac-diplom.com/ http://https://aurus-diplom.com/
https://originality-diplomans.com/
https://rudiplomista24.com/
www.diploma-asx.com
https://gosznac-diplom.com/ https://aurus-diplom.com/
http://https://originality-diplomans.com/
https://rudiplomista24.com/
https://lands-diplom.com/
www.gosznac-diplom.com http://https://aurus-diplom.com/
http://diplomsagroups.com/diplomy-po-specialnosti/diplom-buhgaltera.html www.originality-diploman24.com https://originality-diplomans.com/ https://originality-diploma24.com/- http://https://frees-diploma.com https://ekaterinburg.arena-diplomi24.com/ http://https://ekaterinburg.arena-diplomi24.com/