Quantitative Ultrasound and Bone Mineral Density Are Equally Strongly Associated with Risk Factors for Osteoporosis

Abstract

Because resources do not allow all women to be screened for osteoporosis, clinical risk factors are often used to identify those individuals at increased risk of fracture who are then assessed by bone densitometry. The aim of this study was to compare calcaneal quantitative ultrasound (QUS) and axial bone mineral density (BMD) T and Z scores in a large group of women, some with no clinical risk factors and others with one or more risk factors for osteoporosis. The study population consisted of 1115 pre-and postmenopausal women. A subgroup of 530 women was used to construct reference data for calculating T and Z scores. A total of 786 women was found to have one or more of the following risk factors: (i) atraumatic fracture since the age of 25 years, (ii) report of X-ray osteopenia, (iii) predisposing medical condition or use of therapy known to affect bone metabolism, (iv) premature menopause before the age of 45 years or a history of amenorrhea of longer than 6 months duration, (v) family history of osteoporosis, (vi) body mass index (BMI) <20 kg/m 2 , and (vii) current smoking habit. Calcaneal broadband ultrasound attenuation (BUA) and speed of sound (SOS) measurements were performed on a Hologic Sahara and a DTUone and BMD was measured at the spine and hip using dual-energy X-ray absorptiometry (DXA). The Z score decrements associated with the seven risk factors calculated using multivariate regression analysis were similar for QUS and BMD measurements. Z score decrements (mean of BMD and QUS measurements combined) associated with a history of atraumatic fracture (؊0.67), X-ray osteopenia (؊0.36), a family history of osteoporosis (؊0.23), and a low BMI (؊0.53) were all statistically significant compared with women with no risk factors. Z score decrements associated with a medical condition or use of therapy known to affect bone metabolism, a premature menopause or prolonged amenorrhea, or those who were current smokers were not significantly different from zero. As the number of risk factors present in each individual increased, the mean Z score decrements became more negative, increasing from ؊0.28 for women with one risk factor to ؊1.19 for those with four or more risk factors. QUS and BMD measurements yielded similar mean Z scores for women with one, two, three, or more than four risk factors.

Association of estrogen receptor alpha gene polymorphisms and lifestyle factors with calcaneal quantitative ultrasound and osteoporosis in postmenopausal Vietnamese women

“…First, using SOS measurements is not known as a ''gold standard'' to diagnosis osteoporosis in the hospital, but rather BMD measured by dual-energy X-ray absorptiometry. However, many studies have supported the view of using QUS to screen for osteoporosis at the community level (Gluer 1997;Danielson et al 1999;Frost et al 2001;Hien et al 2005). The previous studies also applied a T-score threshold of £-1.8 to define osteoporosis by using QUS (Frost et al 2001 andHien el al.…”

“…The heritability estimates of the QUS parameters are also comparable with those of BMD, ranging between 53 and 74% at the calcaneus (Danielson et al 1999;Howard et al 1998). More importantly, the proportion of postmenopausal women classified as normal, osteopenic or osteoporotic was similar when using either BMD or QUS measurements (Frost et al 2001;Huopio et al 2004). However, in contrast to the many reports using BMD, genetic studies using QUS measurements are extremely rare.…”

Quantitative ultrasound and bone health

“…Frost et al reported calcaneal QUS to be as sensitive as BMD measurements to clinical risk factors for osteoporosis. 65 Stewart et al also reported QUS measurements to be sensitive to clinical risk factors for osteoporosis, but reported the strength of the association to be dependent upon the type of QUS device and the variable measured. 66 Other studies have reported QUS parameters to be decreased in subjects with renal disease, 67,68 Crohn's disease, 69 primary hyperparathyroism, [70][71][72][73] Rheumatoid arthritis 74 and glucocorticoid use.…”

Detección de osteoporosis en mujeres posmenopáusicas en farmacia comunitaria

“…It is currently proposed as a fast, economic, radiation-free alternative for evaluating the bone mass. 11,12 Benefiting from these advantages, the present study was proposed in a community pharmacy, with the following most important objectives:…”

“…16,17 • The QUI screening strategy can be converted into an option for situations in which the osteoporosis diagnosis is defective, due to the difficulties of gaining access to DXA equipment. The determining of MBD in the heel bone will be of great value if it leads to positive actions in influencing the risk of developing osteoporosis.…”