Evaluation of the Predictive Index for Osteoporosis as a Clinical Tool to Identify the Risk of Osteoporosis in Korean Men by Using the Korea National Health and Nutrition Examination Survey Data

BACKGROUND We previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey. METHODS Participants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared. RESULTS Both indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737. CONCLUSION The Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50-69 years.