Application of Machine Learning on Health Examination Data for Predicting the Decrease of Bone Mineral Densit

Authors

  • Bohan Li Health Management Center, The Second Hospital of Shandong University, Shandong 250033, China
  • Dongjin Wu Spine Surgery, The Second Hospital of Shandong University, Shandong 250033, China.
  • Xiaoqian Kong Health Management Center, The Second Hospital of Shandong University, Shandong 250033, China.
  • Yan Shi Health Management Center, The Second Hospital of Shandong University, Shandong 250033, China.
  • Chunzheng Gao Spine Surgery, The Second Hospital of Shandong University, Shandong 250033, China.
  • Yixin Li Health Management Center, The Second Hospital of Shandong University, Shandong 250033, China

Keywords:

machine learning, KNN, RF, SVM, ANN, LR, osteoporosis, osteopenia, bone mineral density

Abstract

Background: Early detection and preventive measures for reduced bone density can greatly improve patients' quality of life and reduce economic burdens. This study aimed to develop machine learning algorithms that can accurately predict the risk of bone mineral density loss. Methods: The study included participants aged 40 years and older who underwent health evaluations at an affiliated institution from January 2022 to January 2024. Five machine learning algorithms were used to predict the risk of osteoporosis: k-nearest neighbor (KNN), random forest (RF), support vector machine (SVM), artificial neural network (ANN), and logistic regression (LR). The performances were evaluated based on accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC). Results: This study included 11132 patients, of whom 3568 had decreased bone density. The initial dataset contains 17 variables. After the data screening, 13 variables were included in the machine learning model. The AUROC for ANN, KNN, LR, RF, and SVM were 0.882, 0.906, 0.684, 0.918, and 0.896 for males, and 0.881, 0.843, 0.784, 0.922, and 0.872 for females, respectively. The accuracies of ANN, KNN, LR, RF, and SVM were 0.83, 0.86, 0.75, 0.88, 0.82 for males, and 0.81, 0.77, 0.74, 0.85, 0.79 for females. Conclusion: In this study, we developed five machine learning models to predict bone density reduction accurately. The RF model performed best in both male and female populations, with the highest AUROC. Application of machine learning models in clinical settings can help improve the prevention, detection, and early treatment of bone density reduction.

References

Li H, Xiao Z, Quarles LD, Li W. Osteoporosis: mechanism, molecular target, and current status on drug development. Curr Med Chem. 2021;28(8):1489-507.

Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761-7.

Pan B, Cai J, Zhao P, et al. Relationship between prevalence and risk of osteoporosis or osteoporotic fracture with non-alcoholic fatty liver disease: A systematic review and meta-analysis. Osteoporos Int. 2022;33(11):2275-86.

Wang Y, Tao Y, Hyman ME, Li J, Chen Y. Osteoporosis in China. Osteoporos Int. 2009;20(10):1651-62.

Zeng Q, Li N, Wang Q, et al. The prevalence of osteoporosis in china, a nationwide, multicenter DXA survey. J Bone Miner Res. 2019;34(10):1789-97.

Si L, Winzenberg TM, Jiang Q, Chen M, Palmer AJ. Projection of osteoporosis-related fractures and costs in China: 2010-2050. Osteoporos Int. 2015;26(7):1929-37.

Johnell O, Kanis JA. An estimate of the worldwide prevalence, mortality, and disability associated with hip fracture. Osteoporos Int. 2004;15(11):897-902.

Perrier-Cornet J, Omorou AY, Fauny M, Loeuille D, Chary-Valckenaere I. Opportunistic screening for osteoporosis using thoraco-abdomino-pelvic CT-scan assessing the vertebral density in rheumatoid arthritis patients. Osteoporos Int. 2019;30(6):1215-22.

Kwon D, Kim J, Lee H, et al. Quantitative computed tomographic evaluation of bone mineral density in beagle dogs: comparison with dual-energy x-ray absorptiometry as a gold standard. J Vet Med Sci. 2018;80(4):620-8.

Engelke K. Quantitative computed tomography-current status and new developments. J Clin Densitom. 2017;20(3):309-21.

Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994;4(6):368-81.

LeBoff MS, Greenspan SL, Insogna KL, et al. The clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2022;33(10):2049-102.

Zhang S, Wu S, Xia B, et al. Association of coffee and tea consumption with osteoporosis risk: A prospective study from the UK biobank. Bone. 2024;186:117135.

Zhao H, Jia H, Jiang Y, et al. Associations of sleep behaviors and genetic risk with risk of incident osteoporosis: A prospective cohort study of 293,164 participants. Bone. 2024;186:117168.

Koh LK, Sedrine WB, Torralba TP, et al. A simple tool to identify asian women at increased risk of osteoporosis. Osteoporos Int. 2001;12(8):699-705.

Choi RY, Coyner AS, Kalpathy-Cramer J, Chiang MF, Campbell JP. Introduction to machine learning, neural networks, and deep learning. Transl Vis Sci Technol. 2020;9(2):14.

Mintz Y, Brodie R. Introduction to artificial intelligence in medicine. Minim Invasive Ther Allied Technol. 2019;28(2):73-81.

Pickhardt PJ, Nguyen T, Perez AA, et al. Improved CT-based osteoporosis assessment with a fully automated deep learning tool. Radiol Artif Intell. 2022;4(5):e220042.

Chen YC, Li YT, Kuo PC, et al. Automatic segmentation and radiomic texture analysis for osteoporosis screening using chest low-dose computed tomography. Eur Radiol. 2023;33(7):5097-106.

Yang Q, Cheng H, Qin J, et al. A machine learning-based preclinical osteoporosis screening tool (POST): Model development and validation study. JMIR Aging. 2023;6:e46791.

Qiu C, Su K, Luo Z, et al. Developing and comparing deep learning and machine learning algorithms for osteoporosis risk prediction. Front Artif Intell. 2024;7:1355287.

Anthamatten A, Parish A. Clinical update on osteoporosis. J Midwifery Women's Health. 2019;64(3):265-75.

Sedrine WB, Chevallier T, Zegels B, et al. Development and assessment of the osteoporosis index of risk (OSIRIS) to facilitate selection of women for bone densitometry. Gynecol Endocrinol. 2002;16(3):245-50.

Lydick E, Cook K, Turpin J, Melton M, Stine R, Byrnes C. Development and validation of a simple questionnaire to facilitate identification of women likely to have low bone density. Am J Manag Care. 1998;4(1):37-48.

Cadarette SM, Jaglal SB, Kreiger N, McIsaac WJ, Darlington GA, Tu JV. Development and validation of the osteoporosis risk assessment instrument to facilitate selection of women for bone densitometry. CMAJ. 2000;162(9):1289-94.

Badillo S, Banfai B, Birzele F, et al. An introduction to machine learning. Clin Pharmacol Ther. 2020;107(4):871-85.

Kim SK, Yoo TK, Oh E, Kim DW. Osteoporosis risk prediction using machine learning and conventional methods. Annu Int Conf IEEE Eng Med Biol Soc. 2013;2013:188-91.

Shim JG, Kim DW, Ryu KH, et al. Application of machine learning approaches for osteoporosis risk prediction in postmenopausal women. Arch Osteoporos. 2020;15(1):169.

Meng J, Sun N, Chen Y, et al. Artificial neural network optimizes self-examination of osteoporosis risk in women. J Int Med Res. 2019;47(7):3088-98.

Ou Yang WY, Lai CC, Tsou MT, Hwang LC. Development of machine learning models for prediction of osteoporosis from clinical health examination data. Int J Environ Res Public Health. 2021;18(14).

Chiu CT, Lee JI, Lu CC, Huang SP, Chen SC, Geng JH. The association between body mass index and osteoporosis in a Taiwanese population: a cross-sectional and longitudinal study. Sci Rep. 2024;14(1):8509.

Montanari NR, Ramírez R, Aggarwal A, et al. Multi-parametric analysis of human livers reveals variation in intrahepatic inflammation across phases of chronic hepatitis B infection. J Hepatol. 2022;77(2):332-43.

Zheng X-Q, Lin J-L, Huang J, Wu T, Song C-L. Targeting aging with the healthy skeletal system: The endocrine role of bone. Rev Endocr Metab Disord. 2023;24(4):695-711.

Leung KS, Fung KP, Sher AH, Li CK, Lee KM. Plasma bone-specific alkaline phosphatase as an indicator of osteoblastic activity. J Bone Joint Surg Br. 1993;75(2):288-92.

Huh JH, Choi SI, Lim JS, Chung CH, Shin JY, Lee MY. Lower serum creatinine is associated with low bone mineral density in subjects without overt nephropathy. PLoS One. 2015;10(7):e0133062.

Yan DD, Wang J, Hou XH, et al. Association of serum uric acid levels with osteoporosis and bone turnover markers in a Chinese population. Acta Pharmacol Sin. 2018;39(4):626-32.

Lian XL, Zhang YP, Li X, Jing LD, Cairang ZM, Gou JQ. Exploration of the relationship between elderly osteoporosis and cardiovascular disease risk factors. Eur Rev Med Pharmacol Sci. 2017;21(19):4386-90.

Downloads

Published

2025-10-03

How to Cite

Li, B., Wu, D., Kong, X., Shi, Y., Gao, C., & Li, Y. (2025). Application of Machine Learning on Health Examination Data for Predicting the Decrease of Bone Mineral Densit. Acta Medica Indonesiana, 57(3), 332. Retrieved from http://www.actamedindones.org/index.php/ijim/article/view/2957