HISTORICAL ASSESSMENT OF RISK-FACTORS IN SCREENING FOR OSTEOPENIA IN A NORMAL CAUCASIAN POPULATION

Background: Bone mineral density (BMD) can predict fracture, however, the common use of historical risk factors to predict low BMD is unprov en. Aims: To identify significant historical risk factors for osteopen ia. To establish predicting equations for BMD and test their ability t o identify those who should be referred for BMD scanning. Methods: Thr ee hundred and twenty female and 131 male volunteers underwent questio nnaire assessment of risk factors and BMD by dual photon absorptiomete r at hip and spine. Significant risk factors (P < 0.05) were used to c onstruct a linear regression model to predict BMD. This was cross vali dated on a second sample of 107 females and 131 males selected from th e electoral roll analysing the ability to detect those subjects with B MD in the lower third of the age matched normal range. Results: In wom en lower BMD at the spine was associated with increased age, decreased weight, smoking, and delayed menarche. Lower femoral BMD was associat ed with increased age, decreased weight, family history, inactivity, a nd smoking. In men lower BMD at the lumbar spine was associated with l ower weight, and inactivity. Lower BMD at the femur was associated wit h increased age, decreased weight, family history, and low calcium int ake. When cross validated on the second sample, the models produced se nsitivity of 86-89% and sensitivity of 25-46%. Referring those with th ese risk factors could save 10-23% on scanning. Measuring BMD at the s ite in question remains the only accurate way of assessing an individu al's risk of osteopenia.