Comparison of quantitative ultrasound of the phalanges with conventional bone densitometry in healthy postmenopausal women.
The objective of this study was to evaluate the utility of the quantitative ultrasound (QUS) technique for the identification of subjects with spine fracture or low bone mineral density (BMD) previously determined by dual energy X-ray absorptiometry (DEXA). QUS of the phalanges in 1,350 postmenopausal women (60-83 years old) was compared with DEXA measurements of four skeletal sites (lumbar spine, total hip, femoral neck, and distal radius) of the same subjects. The contribution of body mass index (BMI) was also assessed. Amplitude dependent speed of sound (AD-SoS), ultrasound bone profile index (UBPI), and BMD of all anatomical regions, except for the spine, decreased significantly with increasing age quartiles. QUS parameters correlated weakly but significantly with BMD ( r =0.21-0.31, p <0.01). After adjustment for BMI, the association between QUS parameters and BMD remained unchanged. UBPI was found to be independent of BMI. All techniques and all sites were able to significantly discriminate fractured from non-fractured subjects by receiver operating characteristic (ROC) analysis (area under the curve [AUC]> or =0.60, p <0.0001). AD-SoS and UBPI showed similar fracture discrimination ability of spine, distal radius and total body BMD in terms of odds ratios, but BMD of the total hip and femoral neck showed the best performance in discriminating fractured from non-fractured subjects. In conclusion, QUS assessment of the phalanges correlates moderately with BMD of all skeletal sites and is able to effectively discriminate fractured from non-fractured subjects.
Alexandersen
Peter
P
Center for Clinical and Basic Research, Ballerup Byvej 222, 2750 Ballerup, Denmark. cc@ccbr.dk
de Terlizzi
Francesca
F
Tankó
Laszló B
LB
Bagger
Yu Z
YZ
Christiansen
Claus
C
D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D015519:Bone Density; D004812:Epidemiologic Methods; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016103:Spinal Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D014463:Ultrasonography
Osteoporos Int. 1999;9(4):284-9
10550444
Osteoporos Int. 1998;8(5):393-8
9850344
Lancet. 2002 Jun 1;359(9321):1929-36
12057569
Osteoporos Int. 1999;9(3):193-5
10450405
J Bone Miner Res. 2002 Feb;17 (2):321-30
11811563
Osteoporos Int. 2000;11(3):203-10
10824235
J Bone Miner Res. 2002 Dec;17(12):2222-30
12469916
Osteoporos Int. 1999;10 (5):416-24
10591840
Osteoporos Int. 2002 Aug;13(8):606-12
12181617
Ultrasound Med Biol. 2003 Nov;29(11):1545-50
14654150
Int J Gynaecol Obstet. 1998 Oct;63(1):21-8
9849707
J Bone Miner Res. 1997 Aug;12 (8):1280-8
9258759
Osteoporos Int. 2002;13(2):105-12
11905520
Lancet. 1996 Aug 24;348(9026):511-4
8757153
Osteoporos Int. 2001;12 (6):450-5
11446560
Osteoporos Int. 1997;7(6):550-7
9604051
J Bone Miner Res. 1995 Feb;10 (2):243-9
7754803
J Bone Miner Res. 2003 Jul;18(7):1261-6
12854836
J Bone Miner Res. 2000 Aug;15(8):1603-14
10934660
Calcif Tissue Int. 2000 Jan;66(1):43-6
10602843
Osteoporos Int. 2003 Jan;14 (1):34-43
12577183