title: Performance of phalangeal quantitative ultrasound parameters in the evaluation of reduced bone mineral density assessed by DX in patients with 21 hydroxylase deficiency.
abstract: The purpose of this study was to verify the performance of quantitative ultrasound (QUS) parameters of proximal phalanges in the evaluation of reduced bone mineral density (BMD) in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21 OHD). Seventy patients with 21 OHD (41 females and 29 males), aged between 6-27 y were assessed. The QUS measurements, amplitude-dependent speed of sound (AD-SoS), bone transmission time (BTT), and ultrasound bone profile index (UBPI) were obtained using the BMD Sonic device (IGEA, Carpi, Italy) on the last four proximal phalanges in the non-dominant hand. BMD was determined by dual energy X-ray (DXA) across the total body and lumbar spine (LS). Total body and LS BMD were positively correlated to UBPI, BTT and AD-SoS (correlation coefficients ranged from 0.59-0.72, p < 0.001). In contrast, when comparing patients with normal and low (Z-score < -2) BMD, no differences were found in the QUS parameters. Furthermore, UBPI, BTT and AD-SoS measurements were not effective for diagnosing patients with reduced BMD by receiver operator characteristic curve parameters. Although the AD-SoS, BTT and UBPI showed significant correlations with the data obtained by DXA, they were not effective for diagnosing reduced bone mass in patients with 21 OHD.
authors.affiliation: Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil. Electronic address: ezequiel@fcm.unicamp.br.
authors.forename: Ezequiel M
authors.initials: EM
authors.lastname: Gonçalves
authors.affiliation: Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil; Pediatric Endocrinology Unit, Pediatrics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil; PhD Student Program in Child and Adolescent Health.
authors.forename: Leticia E
authors.initials: LE
authors.lastname: Sewaybricker
authors.affiliation: Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Univ Lisboa, Cruz-Quebrada, Portugal.
authors.forename: Fatima
authors.initials: F
authors.lastname: Baptista
authors.affiliation: Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Univ Lisboa, Cruz-Quebrada, Portugal.
authors.forename: Analiza M
authors.initials: AM
authors.lastname: Silva
authors.affiliation: Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil; Physical Education Department, Center of Health and Biology Sciences, Federal University of Maranhão, São Luis, MA, Brazil.
authors.forename: Wellington R G
authors.initials: WR
authors.lastname: Carvalho
authors.affiliation: Nuclear Medicine Division, Clinical Hospital, University of Campinas, Campinas, SP, Brazil.
authors.forename: Allan O
authors.initials: AO
authors.lastname: Santos
authors.affiliation: Center of Molecular Biology and Genetic Engineering, University of Campinas, Campinas, SP, Brazil.
authors.forename: Maricilda P
authors.initials: MP
authors.lastname: de Mello
authors.affiliation: Pediatric Endocrinology Unit, Pediatrics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.
authors.forename: Sofia H V
authors.initials: SH
authors.lastname: Lemos-Marini
authors.affiliation: Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil; Pediatric Endocrinology Unit, Pediatrics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.
authors.forename: Gil
authors.initials: G
authors.lastname: Guerra
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D000328:Adult; D015519:Bone Density; D002648:Child; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Bone mass; Congenital adrenal hyperplasia; QUS