[Calcaneous ultrasonography as measurement of osteoporosis prevalence in the general population in relation to the diagnostic criterion utilized. Data of the study GIUMO].
BACKGROUND
In recent years, a large number of techniques have been developed to estimate the bone mineral density for the diagnosis of osteoporosis. However, diagnostic criteria established by WHO are invariably applied for the interpretation of dual radiological densitometry (DEXA), which could not be correct in the case of the interpretation of ultrasound.


METHODS
We studied 2,589 randomly chosen people of both sexes, 1,138 males and 1,451 women from 10 to 99 years, in 11 spanish provinces. We carried out a measurement of the following calcaneous ultrasound parameters with the Sahara and Hologic devices: speed of the sound (SOS), coefficient of attenuation of wide band (BUA), index of consistency (QUI) and estimated bone mineral density (est. BMD). The prevalence of osteopenia and osteoporosis was calculated by applying the WHO criteria (osteopenia Tscore < or = 1 and osteoporosis Tscore < or = 2.5) and the prevalence of osteoporosis by applying a Tscore 1.8 as threshold.


RESULTS
According to the WHO criteria, osteoporosis (Tscore < or = 2.5) is seen in 1.5 % males and 5.9 % females from 51 to 70 years, and in 2.6% males and 22.1% females over 70 years. Using a Tscore 1.8 as threshold, osteoporosis prevalence increases to 8.2% males and 21.9% females from 51 to 70 years, and to 8.4% males and 40.9% females over 70 years.


CONCLUSIONS
Osteoporosis prevalence in spanish people of both sexes differs notably when applying the cut off point in a Tscore of 2.5, as WHO recommends, or in a Tscore of 1.8 as is suggested by other authors. Consensus is necessary to establish the appropriate cut off point or threshold for the diagnosis of osteoporosis with quantitative ultrasonography of calcaneum.
Sosa Henríquez
M
M
Unidad Metabólica Osea. Departamento de Ciencias Médicas y Quirúrgicas. Servicio de Medicina Interna. Hospital Universitario Insular. Universidad de Las Palmas de Gran Canaria. Spain. msosa@comlp.es
Saavedra Santana
P
P
Alegre López
J
J
Gómez Alonso
C
C
González Macías
J
J
Guañabens Gay
N
N
Hawkins Carranza
F
F
Lozano Tonkin
C
C
Martínez Izquierdo
M T
MT
Mosquera Martínez
J
J
Muñoz Torres
M
M
Pérez Cano
R
R
Quesada Gómez
J M
JM
Salas Heredia
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D002111:Calcaneus / Q000000981:diagnostic imaging*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D014463:Ultrasonography