Identification of patients with a high risk of osteoporosis. Analysis of risk factors, ultrasonography and DEXA, in a female population in the North East of Italy.
OBJECTIVE
The aim of this observational study is the identification of women at high risk of osteoporosis by using the phalangeal quantitative ultrasound (QUS) value for osteoporosis screening.


METHODS
The study population is composed of 1 152 women between 35 and 79 years old, both premenopausal and postmenopausal. Each woman underwent a questionnaire and phalangeal QUS. One hundred and forty-eight women also underwent dual energy X-ray absorptiometry (DEXA). Osteopenia and osteoporosis, as determined using the amplitude dependent speed of sound (AD-SoS) T-score, identified women at a high risk of fracture. Data were stored and analyzed using SPSS (Statistical Package for Social Science) for Windows.


RESULTS
AD-SoS is significantly higher in premenopausal women than in postmenopausal women without history of hormone replacement therapy (HRT) (P<0.001), if they are over 50 years old. In women 50-59 years old, AD-SoS is significantly higher in premenopausal women than in postmenopausal women with or without HRT history (P<0.001). In postmenopausal women, discriminant analysis found that HRT and years of HRT are the only significant protective factors (P<0.001). In premenopausal and postmenopausal women with no history of HRT use, discriminant analysis demonstrated that early menopause and a family history of osteoporosis are the only significant risk factors (P<0.001).


CONCLUSIONS
Early menopause and a family history of osteoporosis seem to be the greatest risk factors, while HRT seems to be a protective factor. The QUS technique, with DEXA as a secondary test, can be a screening test for the identification of postmenopausal women with a high risk of fracture.
Della Martina
M
M
Department of Obstetrics and Gynaecology, University of Udine, Udine, Italy. m.dellamartina@libero.it
Fabiani
G
G
Biasioli
A
A
Piccoli
V
V
Vascotto
L
L
Driul
L
L
Chittaro
M
M
Marchesoni
D
D
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012307:Risk Factors; D014463:Ultrasonography