Risk identification of osteoporosis in postmenopausal women by a simple algorithm based on ultrasound densitometry and body mass index.
Dual-energy X-ray absorptiometry (DXA) method is the main device for diagnosing osteoporosis; this method, however, involves the use of expensive equipment. Ultrasound method, being portable, noninvasive, and cost-effective, seems to be an appropriate screening device to identify subjects at risk of osteoporosis. Two hundred and twenty-four postmenopausal women (mean age: 57.9+/-6.2yr) were recruited at 2 Menopause Centers. All subjects were assessed by phalangeal Quantitative Ultrasound (QUS) and by DXA at femur and rachis. Applying the first-level screening strategy, the following risk factors were considered: (1) Amplitude Dependent Speed-of-Sound T-score<-1.8 standard deviation (SD) or Ultrasound Bone Profile Index T-score<-1.8SD; (2) body mass index (BMI)<20kg/m(2). BMI identified 25 subjects (11%) of the total population as at risk, the QUS parameters 100 subjects (45%), and the combination of the 2 showed 118 subjects (53%). The percentage of osteoporotics identified by BMI was 17%, by QUS 78%, and by the combination of the two 90%. The sensitivity of this algorithm was 90%; 53% of the subjects would undergo a further densitometric evaluation, the remaining 47% were correctly identified as not at risk. The diagnostic work up proposed appears effective to be indicated for extensive clinical employment, thanks also to its simplicity.
Omodei
Umberto
U
Obstetric and Gynaecologic Clinic, University of Brescia, Brescia, Italy. omodeiu@tin.it
Benussi
Caterina
C
Ramazzotto
Francesca
F
Feller
Michela
M
Gambacciani
Marco
M
D015502:Absorptiometry, Photon; D000465:Algorithms; D015992:Body Mass Index; D015519:Bone Density; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008403:Mass Screening; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014463:Ultrasonography