title: Association between low-frequency ultrasound and hip fractures -- comparison with DXA-based BMD.
abstract: BACKGROUND
  New methods for diagnosing osteoporosis and evaluating fracture risk are being developed. We aim to study the association between low-frequency (LF) axial transmission ultrasound and hip fracture risk in a population-based sample of older women.
  
  
  METHODS
  The study population consisted of 490 community-dwelling women (78-82 years). Ultrasound velocity (V(LF)) at mid-tibia was measured in 2006 using a low-frequency scanning axial transmission device. Bone mineral density (BMD) at proximal femur measured using dual-energy x-ray absorptiometry (DXA) was used as the reference method. The fracture history of the participants was collected from December 1997 until the end of 2010. Lifestyle-related risk factors and mobility were assessed at 1997.
  
  
  RESULTS
  During the total follow-up period (1997-2010), 130 women had one or more fractures, and 20 of them had a hip fracture. Low V(LF) (the lowest quartile) was associated with increased hip fracture risk when compared with V(LF) in the normal range (Odds ratio, OR = 3.3, 95% confidence interval (CI) 1.3-8.4). However, V(LF) was not related to fracture risk when all bone sites were considered. Osteoporotic femoral neck BMD was associated with higher risk of a hip fracture (OR = 4.1, 95% CI 1.6-10.5) and higher risk of any fracture (OR = 2.4, 95% CI 1.6-3.8) compared to the non-osteoporotic femoral neck BMD. Decreased VLF remained a significant risk factor for hip fracture when combined with lifestyle-related risk factors (OR = 3.3, 95% CI 1.2-9.0).
  
  
  CONCLUSIONS
  Low V(LF) was associated with hip fracture risk in older women even when combined with lifestyle-related risk factors. Further development of the method is needed to improve the measurement precision and to confirm the results.
authors.affiliation: Department of Medical Technology, University of Oulu, Institute of Biomedicine, PO Box 5000, FI-90014 Oulu, Finland. mikko.maatta@hiphealth.ca.
authors.forename: Mikko
authors.initials: M
authors.lastname: Määttä
authors.forename: Petro
authors.initials: P
authors.lastname: Moilanen
authors.forename: Jussi
authors.initials: J
authors.lastname: Timonen
authors.forename: Pasi
authors.initials: P
authors.lastname: Pulkkinen
authors.forename: Raija
authors.initials: R
authors.lastname: Korpelainen
authors.forename: Timo
authors.initials: T
authors.lastname: Jämsä
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013977:Tibia / Q000000981:diagnostic imaging; D014463:Ultrasonography