Development and validation of a tool for identifying women with low bone mineral density and low-impact fractures: the So Paulo Osteoporosis Risk Index (SAPORI)

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dc.contributor.author Pinheiro, M. M. [UNIFESP]
dc.contributor.author Reis Neto, Edgard Torres dos [UNIFESP]
dc.contributor.author Machado, F. S. [UNIFESP]
dc.contributor.author Omura, F. [UNIFESP]
dc.contributor.author Szejnfeld, J. [UNIFESP]
dc.contributor.author Szejnfeld, V. L. [UNIFESP]
dc.date.accessioned 2016-01-24T14:27:03Z
dc.date.available 2016-01-24T14:27:03Z
dc.date.issued 2012-04-01
dc.identifier http://dx.doi.org/10.1007/s00198-011-1722-y
dc.identifier.citation Osteoporosis International. London: Springer London Ltd, v. 23, n. 4, p. 1371-1379, 2012.
dc.identifier.issn 0937-941X
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/34746
dc.description.abstract The performance of the So Paulo Osteoporosis Risk Index (SAPORI) was tested in 1,915 women from the original cohort, So Paulo Osteoporosis Study (SAPOS) (N = 4332). This new tool was able to identify women with low bone density (spine and hip) and low-impact fracture, with an area under the receiving operator curve (ROC) of 0.831, 0.724, and 0.689, respectively.A number of studies have demonstrated the clinical relevance of risk factors for identifying individuals at risk of fracture (Fx) and osteoporosis (OP). the SAPOS is an epidemiological study for the assessment of risk factors for Fx and low bone density in women from the community of the metropolitan area of So Paulo, Brazil. the aim of the present study was to develop and validate a tool for identifying women at higher risk for OP and low-impact Fx.A total of 4,332 pre-, peri-, and postmenopausal women were analyzed through a questionnaire addressing risk factors for OP and Fx. All of them performed bone densitometry at the lumbar spine and proximal femur (DPX NT, GE-Lunar). Following the identification of the main risk factors for OP and Fx through multivariate and logistic regression, respectively, the SAPORI was designed and subsequently validated on a second cohort of 1,915 women from the metropolitan community of So Paulo. the performance of this tool was assessed through ROC analysis.The main and significant risk factors associated with low bone density and low-impact Fx were low body weight, advanced age, Caucasian ethnicity, family history of hip Fx, current smoking, and chronic use of glucocorticosteroids. Hormonal replacement therapy and regular physical activity in the previous year played a protective role (p < 0.05). After the statistical adjustments, the SAPORI was able to identify women with low bone density (T-score a parts per thousand currency signaEuro parts per thousand a'2 standard deviations) in the femur, with 91.4% sensitivity, 52% specificity, and an area under the ROC of 0.831 (p < 0.001). At the lumbar spine, the performance was similar (81.5% sensitivity, 50% specificity, and area under ROC of 0.724; p < 0.001). Regarding the identification of low-impact Fx, the sensitivity was 71%, the specificity was 52%, and the area under the ROC was 0.689 (p < 0.001).The SAPORI is a simple, useful, fast, practice, and valid tool for identifying women at higher risk for low bone density and osteoporotic fractures. en
dc.format.extent 1371-1379
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof Osteoporosis International
dc.rights Acesso restrito
dc.subject Bone density en
dc.subject Clinical risk factors en
dc.subject Epidemiology en
dc.subject Fractures en
dc.subject Osteoporosis en
dc.subject Risk assessment tool en
dc.title Development and validation of a tool for identifying women with low bone mineral density and low-impact fractures: the So Paulo Osteoporosis Risk Index (SAPORI) en
dc.type Artigo
dc.rights.license http://www.springer.com/open+access/authors+rights?SGWID=0-176704-12-683201-0
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Fundacao Inst Estudo & Pesquisa Diagnost Imagem
dc.contributor.institution Inst Estudo & Pesquisa Diagnost Imagem FIDI
dc.description.affiliation Universidade Federal de São Paulo, Div Rheumatol, Escola Paulista Med Unifesp EPM, São Paulo, Brazil
dc.description.affiliation Fundacao Inst Estudo & Pesquisa Diagnost Imagem, Bone Densitometry Sect, Fundacao, Brazil
dc.description.affiliation Universidade Federal de São Paulo, Dept Radiol, Escola Paulista Med Unifesp EPM, São Paulo, Brazil
dc.description.affiliation Inst Estudo & Pesquisa Diagnost Imagem FIDI, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Div Rheumatol, Escola Paulista Med Unifesp EPM, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Dept Radiol, Escola Paulista Med Unifesp EPM, São Paulo, Brazil
dc.identifier.doi 10.1007/s00198-011-1722-y
dc.description.source Web of Science
dc.identifier.wos WOS:000301790500019



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