Association between low-frequency ultrasound and hip fractures - comparison with DXA-based BMD

Abstract

BackgroundNew methods for diagnosing osteoporosis and evaluating fracture risk are being developed. We aim to study the association between low-frequency (LF) axial transmission ultrasound and hip fracture risk in a population-based sample of older women.MethodsThe study population consisted of 490 community-dwelling women (78–82 years). Ultrasound velocity (VLF) at mid-tibia was measured in 2006 using a low-frequency scanning axial transmission device. Bone mineral density (BMD) at proximal femur measured using dual-energy x-ray absorptiometry (DXA) was used as the reference method. The fracture history of the participants was collected from December 1997 until the end of 2010. Lifestyle-related risk factors and mobility were assessed at 1997.ResultsDuring the total follow-up period (1997–2010), 130 women had one or more fractures, and 20 of them had a hip fracture. Low VLF (the lowest quartile) was associated with increased hip fracture risk when compared with VLF in the normal range (Odds ratio, OR = 3.3, 95% confidence interval (CI) 1.3-8.4). However, VLF was not related to fracture risk when all bone sites were considered. Osteoporotic femoral neck BMD was associated with higher risk of a hip fracture (OR = 4.1, 95% CI 1.6-10.5) and higher risk of any fracture (OR = 2.4, 95% CI 1.6-3.8) compared to the non-osteoporotic femoral neck BMD. Decreased VLF remained a significant risk factor for hip fracture when combined with lifestyle-related risk factors (OR = 3.3, 95% CI 1.2-9.0).ConclusionLow VLF was associated with hip fracture risk in older women even when combined with lifestyle-related risk factors. Further development of the method is needed to improve the measurement precision and to confirm the results.

Ultrasound-Based Estimates of Cortical Bone Thickness and Porosity Are Associated With Nontraumatic Fractures in Postmenopausal Women: A Pilot Study

“…To the best of our knowledge, this study reports, for the first time, the concurrent in vivo estimates of two cortical bone quality markers, Ct.Th and Ct.Po, using an US modality based on the propagation of guided waves and their association with fractures. Some earlier studies have reported on fracture discrimination with US axial transmission measurements at high (approximately 1.0 MHz) or low frequencies (approximately 250 kHz) on the radius or tibia . Unlike these earlier studies relying on the FAS velocity, the estimated QUS parameters here were not directly measured, but were derived from a model‐based inverse problem approach that was previously validated.…”

“…Some earlier studies have reported on fracture discrimination with US axial transmission measurements at high (approximately 1.0 MHz) or low frequencies (approximately 250 kHz) on the radius or tibia. (21,22,24,(48)(49)(50) Unlike these earlier studies relying on the FAS velocity, the estimated QUS parameters here were not directly measured, but were derived from a model-based inverse problem approach that was previously validated. This procedure, applied in vivo at the one-third distal radius of healthy subjects, yielded thickness estimates in good agreement with ground truth values derived from site-matched HRpQCT measurements.…”