oa Journal of Endocrinology, Metabolism and Diabetes in South Africa - Cut-off values of distal forearm bone density for the diagnosis of central osteoporosis in black postmenopausal South African women : original research



The objective of this study was to establish a triage cut-off point or threshold for peripheral bone mineral density (BMD), applicable to black postmenopausal women, and that could be used as a screening method to differentiate between women with normal BMD, and those with possible central osteoporosis. This was a cross-sectional study design conducted in the North West province. Central and peripheral BMD was measured in 184 black, urban postmenopausal women.

Receiver operating curves (ROC) analysis was used to establish cut-off points. Sensitivity, specificity, positive and negative predictive value, odds ratios and likelihood ratios were determined.
The results showed a prevalence rate of 41.3% for central osteoporosis. The area under the curve (AUC) for osteoporosis at the hip was 0.818, and for the spine, it was 0.771. Using the optimum cut-off point (0.371 g/cm2), our results showed a misclassification rate of ≈ 49% for spine osteoporosis, and a negative predictive value of 0.825. Women who had a forearm BMD below this threshold were ~ 10 times more likely to have osteoporosis of the spine.
We recommend using 0.371 g/cm2 as a cut-off point to differentiate between women who have normal BMD, and those with possible osteoporosis of the spine.


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