Multisite quantitative ultrasound for the prediction of fractures over 5 years of follow-up: The Canadian Multicentre Osteoporosis Study

Abstract

This study assessed the ability of multisite quantitative ultrasound (mQUS) to predict fracture over a 5-year follow-up. Participants were a subset of the Canadian Multicentre Osteoporosis Study. mQUS-assessed speed of sound (SOS in m/s) at three sites (distal radius, tibia, and phalanx) and extensive questionnaires were completed, after which participants were followed for 5 years and incident fractures recorded. Two survival analyses were completed for each site-a univariate analysis and an adjusted multivariate analysis controlling for age, antiresorptive use, femoral neck bone mineral density, number of diseases, previous fractures, body mass index (BMI), parental history of hip fracture, current smoking, current alcoholic drinks >3 per day, current use of glucocorticoids, and rheumatoid arthritis diagnosis (variables from the FRAX 10-year fracture risk assessment tool). The unit of change for regression analyses was one standard deviation for all measurement sites, specific to site and sex. Separate analyses were completed for all clinical fractures, nonvertebral fractures, and hip fractures by sex. There were 2633 women and 1108 men included, and they experienced 204 incident fractures over 5 years (5.5% fractured). Univariate models revealed statistically significant (p < 0.05) predictive ability of mQUS for all three measurement sites for women alone for all three fracture types (one standard deviation decrease in SOS was associated with a 52% to 130% increase in the risk of fracture), but not for the men's group. The adjusted model found that measures at the distal radius and tibia in the women's group could significantly (p < 0.05) predict all clinical fractures and nonvertebral fractures within the next 5 years (one standard deviation decrease in SOS was associated with a 25% to 31% increase in the risk of fracture). mQUS provided significant 5-year clinical fracture prediction in women, independent of bone mineral density and other significant risk factors for fracture, when measured at the distal radius and tibia sites.

Ultrasound Speed of Sound Measurements in Trabecular Bone Using the Echographic Response of a Metallic Pin

“…Moreover, as ultrasound is composed of mechanical waves, it can be used to retrieve useful information on bone biomechanical properties and therefore provide information additional to that provided by bone mineral density (BMD) estimation alone (Ha€ ıat et al 2008a). QUS is now widely used in the clinic in the context of osteoporosis to estimate bone quality at such sites as the calcaneum (Chin and Ima-Nirwana 2013), phalanx (Olszynski et al 2013), tibia (Maatta et al 2014), femur (Barkmann et al 2008) and radius (Sasso et al 2009) using transverse (Mathieu et al 2013) and axial (Tatarinov et al 2014) transmission devices. Speed of sound (SOS) is a QUS parameter (Haiat et al 2005b) that has been found to be related to bone strength (Haiat et al 2009b).…”

Comparison of Speed of Sound Measures Assessed by Multisite Quantitative Ultrasound to Bone Mineral Density Measures Assessed by Dual-Energy X-Ray Absorptiometry in a Large Canadian Cohort: the Canadian Multicentre Osteoporosis Study (CaMos)

“…As BMD and SOS are known to both decline with increasing age (1,16) and that BMD is altered by mass (17), partial correlations were conducted controlling for age, mass, and height (exploratory) separately and for all 3 combined. Linear regression was also conducted with each of the 3 SOS sites as a dependent variable with all BMD sites, age, mass, and height as predictor variables.…”

“…The Beam-Med Omnisense multisite quantitative ultrasound (mQUS) has been proven to prospectively predict fracture risk in women older than a 5-yr follow-up (1). The mQUS device assesses bone at distal radius (DR), tibia (TIB), and phalanx (PX) sites and provides an estimate of bone stiffness, expressed as speed of sound (SOS, in m/s).…”

Glucocorticoid-induced osteoporosis: an overview

“…QU is able to diagnose low BMD in GIOP and to predict future fractures [45], but its role in monitoring BMD changes and in predicting fracture risk in daily practice remains unclear.…”