The correlation between calcaneus stiffness index calculated by QUS and total body BMD assessed by DXA in Chinese children and adolescents

Abstract

Few studies have shown comparison data between calcaneus stiffness index (SI) calculated by quantitative ultrasound (QUS) and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) in the Chinese population. This study was aimed to examine the correlations between calcaneus SI calculated by QUS and total body BMD and bone mineral content (BMC) measured by DXA in Chinese children and adolescents. We measured the total body BMD and BMC using Lunar Prodigy (GE Healthcare), and speed of sound (SOS), broadband ultrasound attenuation (BUA), and a calculated SI of the left os calcis using Lunar Achilles Express (GE Healthcare) in 392 healthy Chinese schoolchildren and adolescents aged 5-19 years. The short-term precision for DXA was 0.5 % for total body BMD. The precision for QUS was 1.8 % for SI, 2.9 % for BUA, and 0.4 % for SOS. Pearson's correlation coefficients (r) were calculated to assess the possible correlations between the total body BMC by DXA and SI calculated by QUS. There were significantly positive correlations between SI of the left os calcis and total body BMD (r = 0.693, p < 0.001, n = 392) and BMC (r = 0.690, p < 0.001, n = 392). For all the subjects, significant positive correlations were observed between the calcaneal SI and the age, weight, height, BMI, total body BMD, total body BMC, total body lean mass, and total body fat mass, with r ranging from 0.310 (total body fat mass) to 0.693 (total body BMD) (p < 0.001, n = 392). In conclusion, QUS bone densitometry is a useful measuring method showing the physiological bone development in childhood and adolescence.

Impact of Exercise and Nutrition on Bone Mass

“…The OSI measured by QUS in our study reportedly correlates with the dual X-ray absorptiometry measurement of Bone Mineral Density (BMD) used to diagnose osteoporosis 33) . It is also reportedly eff ective in assessing the risk of bone fractures in the proximity of the femur in post-menopausal women 34,35) and predicting the risk of fractures in various ethnicities 36,37) . Table 3 shows the relationship between the predicted infl uencing factors and the OSI.…”

Agreement Between Dual-Energy X-Ray Absorptiometry and Quantitative Ultrasound to Evaluate Bone Health in Adolescents: The PRO-BONE Study

“…Also, QUS bone outcomes were significantly associated with risk of fractures in older women to a similar extent to DXA (15). Previous studies in children and adolescents indicated significantly positive correlations between DXA and QUS measurements at different skeletal sites (4,18,43). This wide variability might be due to the use of different skeletal sites of measurement because some researchers use the radial site (4), whereas others use the calcaneal site (18,43) as QUS parameters.…”

“…Previous studies in children and adolescents indicated significantly positive correlations between DXA and QUS measurements at different skeletal sites (4,18,43). This wide variability might be due to the use of different skeletal sites of measurement because some researchers use the radial site (4), whereas others use the calcaneal site (18,43) as QUS parameters. In accordance with these previous studies, our data show a wide variability of correlations (r = .15-.58), depending on the region and the QUS parameter assessed.…”

“…Moreover, the SI is the linear combination of BUA and SOS and is considered a better indicator of bone quality than BUA and SOS alone (43). Thus, we used z scores of the SI to find the agreement between DXA and QUS parameters.…”

“…Weeks et al (39) found not only positive and significant correlations between QUS and regional BMC and BMD DXA measurements but also disagreement between both techniques when children (4-18 y old) were ranked by age of peak height velocity quartiles. SI was positively correlated with total body BMD and BMC measured with DXA in children and adolescents (5-17 y old) (43). Similarly, BUA was significantly related to total body BMD in children (7-17 y old) (18).…”