Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women. A prospective study. Study of Osteoporotic Fractures Research Group

Bauer, Douglas C.

doi:10.1001/archinte.157.6.629

Cited by 327 publications

(213 citation statements)

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“…QUS is an established osteodensitometric technique in the diagnosis of postmenopausal osteoporosis and a good predictor of fracture risk. 8,19 This radiation-free technique not only provides information on bone mineral content but also on the micro-architecture of bone, like porosity, trabecular orientation, linkage and elasticity, which are all crucial for the mechanical strength of bone. 5,7 In our study, measurements on 114 term and preterm infants within their first week of life, representing bone mineralization as close as possible to the intrauterine situation and least altered by postnatal influence of nutrition or illness, showed a highly significant correlation of QUS with gestational age and birth weight.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound for the assessment of bone quality in preterm and term infants

Rack

Janni

et al. 2011

J Perinatol

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Objective: As 80% of intrauterine bone mineralization takes place during the last trimester of pregnancy, preterm infants should be supplemented postnatally with optimal doses of calcium, phosphate and vitamin D. Calcium and phosphate excretion in the urine may be used to monitor individual mineral requirements, but are sometimes difficult to interpret. The objective of this study was to assess the value of quantitative ultrasound (QUS) for the analysis of bone status in neonates.Study Design: All admissions to three independent tertiary neonatal intensive care units were studied. In 172 preterm and term infants with a gestational age between 23 and 42 weeks (mean 33.8 ± 5.0) and a birth weight from 405 to 5130 g (mean 2132±1091 g) bone status was evaluated prospectively by quantitative ultrasound velocity using a standardized protocol. Infants were followed in regular intervals up to their first discharge home. While measurements were conducted in weekly intervals initially (n ¼ 55), 2-week intervals were regarded as sufficient thereafter due to limited changes in QUS values within the shorter period. Infants with a birth weight below 1500 g were followed during outpatient visits until up to 17 months of age.Result: The intra-individual day-to-day reproducibility was 0.62%. QUSvalues from the first week of life correlated significantly with gestational age and birth weight (r ¼ 0.5 and r ¼ 0.6; P<0.001). Small-forgestational-age infants showed lower values for QUS than appropriate-forgestational-age infants allowing for their gestational age. Follow-up measurements correlated positively with age and weight during the week of measurement (r ¼ 0.2 and r ¼ 0.4; P ¼ 0.001). Comparing bone quality at 40 weeks of age in infants born at term versus infants born at 24 to 28 weeks, preterm infants showed significantly lower QUS than term infants (P<.0001).There was a significant correlation of QUS with serum alkaline phosphatase (P ¼ 0.003), the supplementation with calcium, phosphate and vitamin D (P< 0.001 each), as well as risk factors for a reduced bone mineralization. No correlation was found between QUS and calcium or phosphate concentration in serum or urine.Conclusion: QUS is a highly reproducible, easily applicable and radiation-free technique that can be used to monitor bone quality in individual newborns. Further prospective randomized-trials are necessary to evaluate, if therapeutic interventions based on QUS are able to prevent osteopenia of prematurity.

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Section: Discussionmentioning

confidence: 99%

Ultrasound for the assessment of bone quality in preterm and term infants

Rack

Janni

et al. 2011

J Perinatol

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“…These technologies are predictive of hip fracture in women over the age of 65, but they cannot be used at the present time for follow-up. 59,60 Peripheral testing may play an important role for women in underserviced areas and in raising awareness about osteoporosis. However, these services may be provided by unregulated practitioners, raising concerns about quality control.…”

Section: Role Of Peripheral Bone Mineral Density Testingmentioning

confidence: 99%

Canadian Consensus Conference on Osteoporosis, 2006 Update

Brown¹,

Fortier²,

Frame

et al. 2006

Journal of Obstetrics and Gynaecology Canada

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Objective-To provide guidelines for the health care provider on the diagnosis and clinical management of postmenopausal osteoporosis.Outcomes-Strategies for identifying and evaluating high-risk individuals, the use of bone mineral density (BMD) and bone turnover markers in assessing diagnosis and response to management, and recommendations regarding nutrition, physical activity, and the selection of pharmacologic therapy to prevent and manage osteoporosis. Values-The quality of evidence is rated using the criteria described in the report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to the method described in this report.

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“…Since then more countries reimburse DXA but may impose certain conditions. In epidemiological studies, Quantitative Ultrasonometry (QUS) bone measurements have also been used to estimate the osteoporotic fracture risk [30][31][32]. QUS is a low-cost, non-invasive method, easy to use and safe, since there is no radiation load on the patient.…”

Section: Where Do We Stand In Europe?mentioning

confidence: 99%