ORIGINAL ARTICLE
Search for secondary osteoporosis: are Z scores useful predictors?
1 Department of Endocrinology, Ninewells Hospital, Dundee, UK
2 MEMO, Division of Medicine & Therapeutics, Ninewells Hospital, Dundee, UK
3 Department of Rheumatology, Perth Royal Infirmary, Perth, UK
4 Department of Medicine, Ninewells Hospital, Dundee, UK
Correspondence to:
Dr K Swaminathan, Wards 1&2, Ninewells Hospital, Dundee DD1 9SY, UK; krishnan.swaminathan{at}nhs.net
Aim: To determine whether Z scores can be used to predict the likelihood of patients having a secondary cause of low bone mineral density.
Methods: A retrospective cross sectional study was conducted among 136 consecutive patients with osteoporosis at Ninewells Hospital, Dundee, UK, between 1998–2002.
Results: 20.5% of female patients in this study were identified with previously unrecognised contributors to the low bone mineral density. In women, at a Z score cut-off of –1, the sensitivity of detecting a secondary cause for osteoporosis is 87.5% with a positive predictive value of 29.2%.
Conclusion: In women, a Z score of –1 would identify a majority of patients with a secondary cause for low bone mineral density and identifies patients who would especially benefit from a thorough history and clinical examination.
Keywords: secondary osteoporosis; risk factors; sensitivity analysis
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