1
|
Wang J, Shu B, Li CG, Xie XW, Liang D, Chen BL, Lin XC, Wei X, Wang L, Leng XY, Zhou YJ, Chen PZ, Tao YR, Zhou Y, Zhang Y, Cui XJ, Lu S, Wang H, Shi Q, Wang YJ. Polymorphisms of genes related to vitamin D metabolism and transportation and its relationship with the risk of osteoporosis: protocol for a multicentre prospective cohort study in China. BMJ Open 2019; 9:e028084. [PMID: 31767578 PMCID: PMC6886991 DOI: 10.1136/bmjopen-2018-028084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Osteoporotic fracture is one of the most common causes of disability and a major contributor to medical care costs in many regions of the world. The polymorphisms of genes related to vitamin D metabolism and transportation are associated with variation in bone mineral density and the risk of osteoporosis. METHODS AND ANALYSIS The China Community-based Cohort of Osteoporosis study is an observational, longitudinal, multicentre, prospective cohort study for middle-aged and older permanent residents of China, which has been ongoing in six cities since 2016. Female residents aged 45-80 years old and male residents aged 50-80 years old are identified through permanent resident lists. All the enrolled participants will complete questionnaires on their personal characteristics and histories. The bone mineral density of their lumbar vertebrae and left hip will be measured and serum bone metabolism parameters assessed. Polymorphisms of genes related to vitamin D metabolism and transportation will be detected, and their relationship with the risk of osteoporosis, and osteoporotic fracture, will be analysed. About 18 000 residents will be involved in the study. ETHICS AND DISSEMINATION The study was approved by Institutional Ethics Board of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (2016LCSY065). Results will be published in peer-reviewed journals. The results of this study are expected to improve the understanding of the association between polymorphisms of genes related to vitamin D metabolism and transportation and the risk of osteoporosis and osteoporotic fracture among middle-aged and older residents of China. TRIAL REGISTRATION NUMBER NCT02958020.
Collapse
Affiliation(s)
- Jing Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Shanghai Geriatric Institute of Chinese Medicine, Shanghai, China
| | - Bing Shu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen-Guang Li
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Xing-Wen Xie
- Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, China
| | - De Liang
- The First Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Bo-Lai Chen
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Xin-Chao Lin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Wei
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Liang Wang
- The 309th Hospital of Chinese People's Liberation Army, Beijing, China
| | - Xiang-Yang Leng
- Hospital Affiliated to Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Ying-Jie Zhou
- Luoyang Zhenggu Hospital of Henan Province, Luoyang, China
| | - Pei-Zhan Chen
- Clinical Research Center, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Ren Tao
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Yong Zhou
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yan Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xue-Jun Cui
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Sheng Lu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Shi
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Yong-Jun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
2
|
The ability of calcaneal and multisite quantitative ultrasound variables in the identification of osteoporosis in women and men. Turk J Phys Med Rehabil 2019; 65:203-215. [PMID: 31663068 DOI: 10.5606/tftrd.2019.1894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 12/10/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives The aim of this study was to assess the ability of calcaneal and multisite quantitative ultrasound (QUS) parameters in the identification of osteoporosis in women and men. Patients and methods A total of 131 women (mean age 53.7±11.9 years; range, 21 to 79 years) and 109 men (mean age 57.8±13.7 years; range, 24 to 85 years) whose bone mineral density (BMD) at the spine and proximal femur was measured between January 2010 and January 2012, using dual-energy X-ray absorptiometry (DXA) were included. Acoustic bone properties were also examined using both a calcaneal and a multisite QUS. The receiver operating characteristic analysis with the calculation of areas under the curve (AUCs) to evaluate the ability of both QUS devices for the identification of osteoporosis. We also calculated a lower and an upper threshold at a specificity of 90% and at a sensitivity of 90%, respectively, for the identification of osteoporosis along with a threshold/cut-off value with the best compromise between sensitivity and specificity. Results All calcaneal QUS parameters showed significant AUCs within the range of 0.712 (for Broadband Ultrasound Attenuation [BUA]) and 0.764 (for Speed of Sound [SOS]) in women and ranging from 0.661 (for BUA) to 0.735 (for SOS) in men, while only radial SOS of the multisite QUS demonstrated a significant AUC value of 0.661 for identifying osteoporosis in women. A Quantitative Ultrasound Index T-score of -1.53 for women and -1.68 for men showed sensitivity and specificities around 70%. Conclusion Based on the results of this study, all calcaneal QUS parameters in both women and men and possibly radial SOS measurements of the multisite QUS in women may be helpful for the identification of osteoporosis.
Collapse
|
3
|
Yang KC, Wang ST, Lee JJ, Fann JCY, Chiu SYH, Chen SLS, Yen AMF, Chen HH, Chen MK, Hung HF. Bone mineral density as a dose-response predictor for osteoporosis: a propensity score analysis of longitudinal incident study (KCIS no. 39). QJM 2019; 112:327-333. [PMID: 30629251 DOI: 10.1093/qjmed/hcz009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Osteoporosis is a global disease burden for aging society. The role of quantitative ultrasound (QUS) in the prediction for osteoporosis in a dose-response manner is hardly addressed. AIM We aimed to show the dose-response of QUS measurement in the prediction for osteoporosis by a community-based study. DESIGN A prospective cohort study. METHODS Participants were recruited between 2000 and 2004. Demographic data and heel QUS measurement were collected at baseline. Diagnosis of osteoporosis was ascertained by the follow-up of this cohort over time. In order to reduce the imbalance of baseline characteristics in the observational study, we applied propensity score by using proportional odds regression analysis to match the quintiles of QUS T-score. RESULTS A total of 44 957 subjects composed of 17 678 men (39.3%) and 27 279 women (69.7%) were recruited. After adjustments for propensity score, an increase in one unit of QUB T-score led to 7% reduction in the risk for osteoporosis [adjusted odds ratio (OR) = 0.93, 95% confidence interval (CI): 0.89-0.96, P < 0.0001]. Higher quintile of QUS T-score yielded a lower risk of osteoporosis with a gradient relationship [OR: 0.82 (95%CI: 0.72-0.92); OR: 0.81 (95%CI: 0.71-0.91); OR: 0.77 (95%CI: 0.68-0.87) and OR: 0.76 (95%CI: 0.67-0.86)] from the second to highest quintile opposed to first quintile (P < 0.0001). The cumulative incidence of osteoporosis was higher in the lower quintile during follow-up (log-rank test, P < 0.001). CONCLUSION QUS is an independent predictor for osteoporosis in a dose-response manner using a large population-based cohort. Due to the lower cost and portability of QUS measurement, the pre-screening for osteoporosis by QUS can be considered in the area with limited resources can be a feasible and alternative method.
Collapse
Affiliation(s)
- K-C Yang
- Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
- Health Science and Wellness Center, National Taiwan University, Taipei, Taiwan
| | - S-T Wang
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Health Management Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - J J Lee
- Department of Family Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - J C-Y Fann
- Department of Health Industry Management, School of Healthcare Management, Kainan University, Tao-Yuan, Taiwan
| | - S Y-H Chiu
- Department of Health Care Management and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - S L-S Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - A M-F Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - H-H Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - M-K Chen
- Department of Community and Family Medicine, National Taiwan University Hospital Hsinchu Branch, No.25, Lane 442, Sec.1, Jingguo Rd., Hsinchu City, Taiwan
| | - H-F Hung
- Department of Community and Family Medicine, National Taiwan University Hospital Hsinchu Branch, No.25, Lane 442, Sec.1, Jingguo Rd., Hsinchu City, Taiwan
| |
Collapse
|
4
|
Tabor E, Pluskiewicz W, Tabor K. Clinical Conformity Between Heel Ultrasound and Densitometry in Postmenopausal Women: A Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:363-369. [PMID: 28777482 DOI: 10.1002/jum.14340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 05/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To assess the conformity between heel ultrasound and densitometry, and the clinical application of densitometry T-score "gold standard" in quantitative ultrasound as a method of osteoporosis diagnosis in postmenopausal women. METHODS The study is a systematic review of studies published in the last 17 years in PubMed, NLM Gateway, Medline, Embase, and Cochrane Library. Calcaneal quantitative ultrasound sensitivity and specificity were analyzed with regard to densitometry measurements in postmenopausal women. In addition, we summarized the values of ultrasound T-scores, for which their accuracy in osteoporosis diagnosis is the highest. RESULTS The inclusion criteria met 15 research studies conducted on postmenopausal women. In 11 of them, the authors concluded that clinical conformity between heel ultrasound and densitometry is good. The recommended quantitative ultrasound T-score for osteoporosis diagnosis ranged between -1 and -3.65. CONCLUSIONS Heel ultrasound should be considered to be as accurate as densitometry in diagnosing osteoporosis. Nevertheless, it needs to have separate T-score ranges determined, because those used in densitometry are not adequate.
Collapse
Affiliation(s)
- Elżbieta Tabor
- School of Medicine, Division of Dentistry, Doctoral Studies, Medical University of Silesia in Katowice, Poland
| | - Wojciech Pluskiewicz
- Medical University of Silesia in Katowice, School of Medicine with the Division of Dentistry, Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Zabrze, Poland
| | - Kamil Tabor
- School of Medicine, Division of Dentistry, Doctoral Studies, Medical University of Silesia in Katowice, Poland
| |
Collapse
|
5
|
Nagai A, Tajika T, Yamamoto A, Okura C, Kanazawa S, Takagishi K. Relations between quantitative ultrasound assessment of calcaneus and grip and key pinch power in Japanese mountain village residents. J Orthop Surg (Hong Kong) 2017; 25:2309499017690321. [PMID: 28219302 DOI: 10.1177/2309499017690321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE It seems to be important to recognize bone health condition using a simple method in Japanese super-aged society. The aim of our study was to investigate whether grip and key pinch strength were associated with bone quality. METHODS Medical examinations were conducted of 337 adult residents (123 men, 214 women; average age of 64.7 years) of a mountain village. Bilateral grip and key pinch strength were measured. The sound of speed (SOS) of calcaneus was assessed using an ultrasound bone densitometer. Study participants were divided into non-osteoporotic and osteoporotic groups according to the relevant WHO classification to evaluate statistical significance by age-adjusted analysis. Stepwise linear regression was used to identify the predictor of SOS using the following factors as explanatory variables: age, height, weight BMI, grip and key pinch power strength in bilateral side. A P value of < .05 was regarded as statistically significant. RESULTS In age-adjusted analysis, significant associations were found between osteoporosis and BMI (OR 0.87, 95%CI 0.80-0.95), gender (OR 3.21, 95%CI 1.83-5.62), grip strength (right side:, OR 0.95, 95%CI 0.92-0.98; left side: OR 0.95, 95% CI 0.92-0.98) and key pinch strength (right side: OR 0.76, 95%CI 0.65-0.88; left side: OR 0.79, 95%CI 0.68-0.91). In stepwise linear regression, age and left key pinch strength were predictors of calcaneal SOS (age β coefficient = -0.46, P = .00; left key pinch strength β coefficient = 0.17, P = .0049). CONCLUSIONS Key pinch strength assessment might be useful to predict calcaneal SOS in general population.
Collapse
Affiliation(s)
- Ayako Nagai
- 1 Department of Orthopaedic Surgery, Saiseikai Maebashi Hospital, Gunma, Maebashi, Japan
| | - Tsuyoshi Tajika
- 2 Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Maebashi, Japan
| | - Atsushi Yamamoto
- 2 Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Maebashi, Japan
| | - Chisa Okura
- 2 Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Maebashi, Japan
| | - Saeko Kanazawa
- 3 Department of Orthopaedic Surgery, Isesaki Municipal Hospital, Gunma, Isesaki, Japan
| | - Kenji Takagishi
- 2 Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Maebashi, Japan
| |
Collapse
|
6
|
Høiberg MP, Rubin KH, Hermann AP, Brixen K, Abrahamsen B. Diagnostic devices for osteoporosis in the general population: A systematic review. Bone 2016; 92:58-69. [PMID: 27542659 DOI: 10.1016/j.bone.2016.08.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 08/09/2016] [Accepted: 08/14/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A diagnostic gap exists in the current dual photon X-ray absorptiometry (DXA) based diagnostic approach to osteoporosis. Other diagnostic devices have been developed, but no comprehensive review concerning the applicability of these diagnostic devices for population-based screening have been performed. MATERIAL AND METHODS A systematic review of Embase, Medline and the Cochrane Central Register for Controlled Trials was performed for population-based studies that focused on technical methods that could either indicate bone mineral density (BMD) by DXA, substitute for DXA in prediction of fracture risk, or that could have an incremental value in fracture prediction in addition to DXA. Quality of included studies was rated by QUADAS 2. RESULTS Many other technical devices have been tested in a population-based setting. Five studies aiming to indicate BMD and 17 studies aiming to predict fractures were found. Overall, the latter studies had higher methodological quality. The highest number of studies was found for quantitative ultrasound (QUS). The ability to indicate BMD or predict fractures was moderate to minor for all examined devices, using reported area under the curve (AUC) of Receiver Operating Characteristic curves values as standard. CONCLUSIONS Of the methods assessed, only QUS appears capable of perhaps replacing DXA as standalone examination in the future whilst radiographic absorptiometry could provide important information in areas with scarcity of DXA. QUS may be of added value even after DXA has been performed. Evaluation of proposed cutoff-values from population-based studies in separate population-based cohorts is still lacking for most examination devices.
Collapse
Affiliation(s)
- M P Høiberg
- Department of Research, Hospital of Southern Norway, Kristiansand, Norway; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - K H Rubin
- OPEN, Odense Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark, Odense University hospital, Denmark.
| | - A P Hermann
- Department of Medical Endocrinology, Odense University Hospital, Odense, Denmark.
| | - K Brixen
- Department of Medical Endocrinology, Odense University Hospital, Odense, Denmark.
| | - B Abrahamsen
- OPEN, Odense Patient Data Explorative Network, Department of Clinical Research, University of Southern Denmark, Odense University hospital, Denmark; Department of Medicine, Holbæk Hospital, Holbæk, Denmark.
| |
Collapse
|
7
|
Zhang L, Lv H, Zheng H, Li M, Yin P, Peng Y, Gao Y, Zhang L, Tang P. Correlation between Parameters of Calcaneal Quantitative Ultrasound and Hip Structural Analysis in Osteoporotic Fracture Patients. PLoS One 2015; 10:e0145879. [PMID: 26710123 PMCID: PMC4692445 DOI: 10.1371/journal.pone.0145879] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/09/2015] [Indexed: 12/25/2022] Open
Abstract
Background Calcaneal quantitative ultrasound (QUS), which is used in the evaluation of osteoporosis, is believed to be intimately associated with the characteristics of the proximal femur. However, the specific associations of calcaneal QUS with characteristics of the hip sub-regions remain unclear. Design A cross-sectional assessment of 53 osteoporotic patients was performed for the skeletal status of the heel and hip. Methods We prospectively enrolled 53 female osteoporotic patients with femoral fractures. Calcaneal QUS, dual energy X-ray absorptiometry (DXA), and hip structural analysis (HSA) were performed for each patient. Femoral heads were obtained during the surgery, and principal compressive trabeculae (PCT) were extracted by a three-dimensional printing technique-assisted method. Pearson’s correlation between QUS measurement with DXA, HSA-derived parameters and Young’s modulus were calculated in order to evaluate the specific association of QUS with the parameters for the hip sub-regions, including the femoral neck, trochanteric and Ward’s areas, and the femoral shaft, respectively. Results Significant correlations were found between estimated BMD (Est.BMD) and BMD of different sub-regions of proximal femur. However, the correlation coefficient of trochanteric area (r = 0.356, p = 0.009) was higher than that of the neck area (r = 0.297, p = 0.031) and total proximal femur (r = 0.291, p = 0.034). Furthermore, the quantitative ultrasound index (QUI) was significantly correlated with the HSA-derived parameters of the trochanteric area (r value: 0.315–0.356, all p<0.05) as well as with the Young’s modulus of PCT from the femoral head (r = 0.589, p<0.001). Conclusion The calcaneal bone had an intimate association with the trochanteric cancellous bone. To a certain extent, the parameters of the calcaneal QUS can reflect the characteristics of the trochanteric area of the proximal hip, although not specifically reflective of those of the femoral neck or shaft.
Collapse
Affiliation(s)
- Licheng Zhang
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
| | - Houchen Lv
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
| | - Hailiang Zheng
- Department of Bioengineering, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Ming Li
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
| | - Pengbin Yin
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
| | - Ye Peng
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
| | - Yuan Gao
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
| | - Lihai Zhang
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- * E-mail: (PFT); (LHZ)
| | - Peifu Tang
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
- * E-mail: (PFT); (LHZ)
| |
Collapse
|
8
|
Iki M, Tamaki J, Sato Y, Morita A, Ikeda Y, Kajita E, Nishino H, Akiba T, Matsumoto T, Kagamimori S, Kagawa Y, Yoneshima H, Matsukura T, Yamagami T, Kitagawa J. Cohort Profile: The Japanese Population-based Osteoporosis (JPOS) Cohort Study. Int J Epidemiol 2014; 44:405-14. [DOI: 10.1093/ije/dyu084] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
9
|
Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos 2014; 9:182. [PMID: 24847682 DOI: 10.1007/s11657-014-0182-3] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/22/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED In nine industrialized countries in North America, Europe, Japan, and Australia, country-specific osteoporosis prevalence (estimated from published data) at the total hip or hip/spine ranged from 9 to 38 % for women and 1 to 8 % for men. In these countries, osteoporosis affects up to 49 million individuals. PURPOSE Standardized country-specific prevalence estimates are scarce, limiting our ability to anticipate the potential global impact of osteoporosis. This study estimated the prevalence of osteoporosis in several industrialized countries (USA, Canada, five European countries, Australia, and Japan) using the World Health Organization (WHO) bone mineral density (BMD)-based definition of osteoporosis: BMD T-score assessed by dual-energy x-ray absorptiometry ≤-2.5. METHODS Osteoporosis prevalence was estimated for males and females aged 50 years and above using total hip BMD and then either total hip or spine BMD. We compiled published location-specific data, using the National Health and Nutrition Examination Survey (NHANES) III age and BMD reference groups, and adjusted for differences in disease definitions across sources. Relevant NHANES III ratios (e.g., male to female osteoporosis at the total hip) were applied where data were missing for countries outside the USA. Data were extrapolated from geographically similar countries as needed. Population counts for 2010 were used to estimate the number of individuals with osteoporosis in each country. RESULTS For females, osteoporosis prevalence ranged from 9 % (UK) to 15 % (France and Germany) based on total hip BMD and from 16 % (USA) to 38 % (Japan) when spine BMD data were included. For males, prevalence ranged from 1 % (UK) to 4 % (Japan) based on total hip BMD and from 3 % (Canada) to 8 % (France, Germany, Italy, and Spain) when spine BMD data were included. CONCLUSIONS Up to 49 million individuals met the WHO osteoporosis criteria in a number of industrialized countries in North America, Europe, Japan, and Australia.
Collapse
|
10
|
Minematsu A, Hazaki K, Harano A, Iki M, Fujita Y, Okamoto N, Kurumatani N. A screening model for low bone mass in elderly Japanese men using quantitative ultrasound measurements: Fujiwara-Kyo Study. J Clin Densitom 2012; 15:343-50. [PMID: 22677197 DOI: 10.1016/j.jocd.2012.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 02/06/2012] [Accepted: 02/07/2012] [Indexed: 11/24/2022]
Abstract
Screening for low bone mass is important to prevent fragility fractures in men as well as women, although men show a much lower prevalence of osteoporosis than women. The purpose of this study was to establish a screening model for low bone mineral density (BMD) using a quantitative ultrasound parameter and easily obtained objective indices for elderly Japanese men. We examined 1633 men (65-84 yr old) who were subjects of the Fujiwara-Kyo Study. Speed of sound (SOS) at the calcaneus was determined, and BMD was measured by dual-energy X-ray absorptiometry at the lumbar spine (LS), total hip (TH), and femoral neck (FN). Low BMD was defined as >1 standard deviation below the young adult mean, in accordance with World Health Organization criteria. We performed receiver operating characteristic (ROC) analysis to identify a better screening model incorporating SOS and determined the optimal cutoff value using Youden index. Prevalences of low BMD at the 3 skeletal sites were 27.8% (LS), 33.5% (TH), 48.6% (FN), and 43.3% at either LS or TH. The greatest area under the ROC curve (0.806, 95% confidence interval: 0.785-0.828) and smallest Akaike's information criterion were obtained in the multivariate model incorporating SOS, age, height, and weight for predicting low BMD at all skeletal sites. This model predicted low BMD at TH with the sensitivity of 0.726 and specificity of 0.739, whereas a similar model predicted low BMD at LS with much lower validity. We conclude that the multivariate model for TH could be used to screen for low BMD in elderly Japanese men.
Collapse
Affiliation(s)
- Akira Minematsu
- Department of Physical Therapy, Faculty of Health and Science, Kio University, Nara, Japan.
| | | | | | | | | | | | | |
Collapse
|
11
|
Abstract
AbstractQuantitative ultrasound (QUS) is of increasing interest for evaluation of osteoporosis because, compared with dual-energy X-ray absorptiometry (DXA), it is portable, less expensive, and radiation-free. The aim of our study was to determine the sensitivity, specificity, and cut-off values of quantitative ultrasound parameters in identifying patients with osteoporosis compared to the World Health Organization (WHO) standard definition. We performed a cross-sectional investigational study of 73 subjects, and determined total hip and lumbar spine T-scores by dual-energy X-ray absorptiometry (DXA) (Prodigy Advance Lunar-GE). The QUS parameters (broadband ultrasound attenuation [BUA], speed of sound, bone mineral density, the stiffness index, and QUS T-score) were determined with Sahara Hologic equipment. The AUC was 0.81 (95% CI 0.67–0.95, p<0.05) for speed of sound (SOS) and 0.76 (95% CI 0.62–0.90, p<0.05) for BUA for the patients with DXA T-scores ≥ −1 DS; the cut-off values were 1542.2 meters per second for SOS and 63.3 dB/MHz for BUA. In patients with DXA T-scores ≤ − 2.5 DS, AUC was 0.80 (95% CI 0.70–0.90, p<0.05) for SOS, and 0.76 (95% CI 0.65–0.87, p<0.05) for BUA. The cut-off values were 1504.95 meters per second for SOS and 49.5 dB/MHz for BUA. Pearson correlation coefficients were positive and statistically significant (> 50%) for all QUS parameters in both groups, (2-tailed, p<0.05). QUS parameters correctly identified normal patients (false negative 34.21% and false positive 2.53%) and those with osteoporosis (false negative 8.55% and false positive 7.82%). The patients with QUS parameters between the cut-off values corresponding to DXA T-scores of −1 SD and − 2.5 SD should be further evaluated by DXA.
Collapse
|
12
|
Liu W, Xu CL, Zhu ZQ, Han SM, Zu SY, Zhu GJ. Assessment of low quantitative ultrasound values of calcaneus in Chinese mainland women. J Clin Densitom 2006; 9:351-7. [PMID: 16931355 DOI: 10.1016/j.jocd.2006.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Revised: 01/27/2006] [Accepted: 03/15/2006] [Indexed: 10/24/2022]
Abstract
Calcaneus quantitative ultrasound (QUS) assessment is a safe and reliable method for evaluating skeletal status. Until now, considerable data have been accumulated on the distribution of QUS in Caucasian populations, whereas such data are still insufficient in Asian populations, especially in Chinese mainland. The present study aimed to obtain the distribution characteristic of calcaneus QUS in healthy Chinese women, and to further investigate the distribution of low bone mass by QUS stiffness index (SI). This study included 2,498 healthy Chinese females aged 10-87 yr. The QUS exhibited a characteristic mild rise and then fall pattern with increasing age. Age, body height, and weight were significant influencing factors on SI, especially age and weight. The prevalence of osteoporosis detected using instrument-derived T-score or internal T-score was different from that calculated according to calcaneus bone mass density (BMD) previously reported. Furthermore, between instrument-derived T-scores and internal T-scores, there were also significant differences. We concluded that the World Health Organization criteria from BMD may not be appropriate for QUS, and the instrument-derived T-score may also not be appropriate for the studied population. The results will be useful for predicting fracture risk of Chinese women and determining diagnostic criteria of osteoporosis by QUS.
Collapse
Affiliation(s)
- W Liu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | | | | | | | | | | |
Collapse
|
13
|
Yang NP, Jen I, Chuang SY, Chen SH, Chou P. Screening for low bone mass with quantitative ultrasonography in a community without dual-energy X-ray absorptiometry: population-based survey. BMC Musculoskelet Disord 2006; 7:24. [PMID: 16526954 PMCID: PMC1434741 DOI: 10.1186/1471-2474-7-24] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2005] [Accepted: 03/09/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dual-energy x-ray absorptiometry (DXA) is the criterion standard to identify low bone mineral density (BMD), but access to axial DXA may be limited or cost prohibitive. We screened for low bone mass with quantitative ultrasonography (QUS) in a community without DXA, analyzed its reliability and obtained reference values and estimated the prevalence of low QUS values. METHODS We enrolled 6493 residents of Kinmen, Taiwan, and a reference group (96 men and 70 women aged 20-29 years) for this cross-sectional, community-based study. All participants completed a questionnaire and underwent ultrasonographic measurements. Reliability and validity of QUS measurements were evaluated. Broadband ultrasound attenuation (BUA) values were obtained and statistically analyzed by age, sex and weight. Annual loss of BUA was determined. Trends in the prevalence of QUS scores were evaluated. RESULTS Two QUS were used and had a correlation coefficient of 0.90 (p < 0.001). Calcaneal BUA was significantly correlated with BMD in the femoral neck (r = 0.67, p < 0.001) and BMD of the total lumbar spine (r = 0.59, p < 0.001). BUAs in the reference group were 92.72 +/- 13.36 and 87.90 +/- 10.68 dB/MHz for men and women, respectively. Estimated annual losses of calcaneal BUA were 0.83% per year for women, 0.27% per year for men, and 0.51% per year for the total population. The prevalence of severely low QUS values (T-score = -2.5) tended to increase with aging in both sexes (p < 0.001). Across age strata, moderately low QUS values (-2.5 < T-score < -1.0) were 31.6-41.0% in men and 23.7-38.1% in women; a significant trend with age was observed in men (p < 0.001). CONCLUSION Age-related decreases in calcaneal ultrasonometry, which reflected the prevalence of low bone mass, were more obvious in women than in men.
Collapse
Affiliation(s)
- Nan-Ping Yang
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, 155, Li-Nong Street, Section 2, Peitou, Taipei, ROC, Taiwan
- Department of Orthopedic Surgery, Tao-Yuan General Hospital, Department of Health, Executive Yuan, 1492, Jhong-Shan Road, Taoyuan, ROC, Taiwan
| | - Ian Jen
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, 155, Li-Nong Street, Section 2, Peitou, Taipei, ROC, Taiwan
| | - Shao-Yuan Chuang
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, 155, Li-Nong Street, Section 2, Peitou, Taipei, ROC, Taiwan
| | - Shui-Hu Chen
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, 155, Li-Nong Street, Section 2, Peitou, Taipei, ROC, Taiwan
- Kin-Nin Country Health Center, 2, Fu-Hsing Road, Jinhu Town, Kinmen, ROC, Taiwan
| | - Pesus Chou
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, 155, Li-Nong Street, Section 2, Peitou, Taipei, ROC, Taiwan
| |
Collapse
|
14
|
Kastelan D, Kujundzic-Tiljak M, Kraljevic I, Kardum I, Giljevic Z, Korsic M. Calcaneus ultrasound in males: normative data in the Croatian population (ECUM study). J Endocrinol Invest 2006; 29:221-5. [PMID: 16682834 DOI: 10.1007/bf03345543] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Limited number of dual X-ray absorptiometry (DXA) devices in Croatia makes this diagnostic technique unavailable to the majority of the population. Quantitative ultrasound (QUS) of the calcaneus could be an alternative tool for assessing fracture risk. However, age-specific normative data should be obtained before using the QUS in everyday clinical practice. The aim of our Epidemiology of Calcaneus Ultrasound in Males (ECUM) study is to establish the normative QUS data in a healthy sample of Croatian males. A total of 1002 male participants, aged 20-99, recruited in different Croatian counties, were included in the study. In each subject broadband ultrasound attenuation (BUA), speed of sound (SOS) and quantitative ultrasound index (QUI) of the left calcaneus were measured using the Sahara ultrasound device (Hologic). The coefficients of variation were 2.85 for BUA, 0.37 for SOS and 2.49 for QUI. Significant declining with age was found for all three parameters, BUA (p<0.001), SOS (p<0.001) and QUI (p<0.001), with respective r values 0.14, 0.27 and 0.23. The peak SOS (1,562.8+/-28.5 m/sec) and QUI (103.6+/-16.5) values were observed in the third decade, whereas the peak BUA value (86.2+/-19.2 db/MHz) was observed in the fourth decade. A subgroup of 103 participants, aged 20-29, was used to estimate young adult mean and SD for QUI and calculate the T-scores. Using the World Health Organization diagnostic criteria the rates of osteoporosis (T-score<-2.5) in the males aged 50 and older was 5.8%. However, when we used the cut-off value of the T-score<-1.8, as previously suggested, prevalence of osteoporosis in Croatian males >50 yr was 16.2%. Although further studies might improve our understanding of the QUS role in the fracture prediction, we hope that the results presented here will improve the clinical management of osteoporosis in males.
Collapse
Affiliation(s)
- D Kastelan
- Division of Endocrinology, Department of Internal Medicine, University Hospital Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia, Hrvatska.
| | | | | | | | | | | |
Collapse
|
15
|
Magkos F, Manios Y, Babaroutsi E, Sidossis LS. Contralateral differences in quantitative ultrasound of the heel: the importance of side in clinical practice. Osteoporos Int 2005; 16:879-86. [PMID: 15586269 DOI: 10.1007/s00198-004-1761-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2004] [Accepted: 08/31/2004] [Indexed: 11/27/2022]
Abstract
Quantitative ultrasound (QUS) of the heel is becoming increasingly popular for the assessment of skeletal status, although there appears to be a general lack of agreement regarding which side to measure. The purpose of the present study was to evaluate possible side differences (right versus left) in heel QUS within the general population, including children (10-15 years old, n=406), adults (26-33 years old, n=339), and elderly subjects (60-75 years old, n=455) of both genders (818 females and 382 males), and to examine the impact of these differences on prevalence estimates of osteoporosis and individual fracture risk assessment. All participants had both their heels measured twice with the Sahara device, which measures broadband ultrasound attenuation (BUA) and speed of sound (SOS) through the os calcis; a composite parameter, that is, quantitative ultrasound index (QUI) and an estimate of heel BMD (eBMD) were also derived. Significant side differences were detected for BUA and SOS (P<0.05), but not for QUI or eBMD. Contralateral differences were rather small in absolute terms, but were in the order of 12.6% for BUA, 0.72% for SOS, 7.9% for QUI, and 9.9% for eBMD, when expressed as percentage of the mean values for the two heels. Bilateral differences appeared to vary across age and gender. Significant correlations between QUS indices of the right and left heel were observed (r=0.75-0.85; P<0.001), which seemed to be stronger among the elderly and among male individuals. Prevalence rates of osteopenia and osteoporosis were not significantly different when estimated from eBMD T-scores for the one or the other foot (chi(2)=1.781, df=2, P=0.410). However, cross-classification analysis revealed that only 84% of the subjects classified into each risk category by the two calcanei were actually the same persons. In conclusion, results from the present study strongly suggest that QUS measurements of opposite heels may not be equivalent with respect to the evaluation of bone status and classification of individual fracture risk assessment, although the degree of discrepancy appears to be related to the primary outcome of interest.
Collapse
Affiliation(s)
- Faidon Magkos
- Laboratory of Nutrition and Clinical Dietetics, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Avenue, 17671 Athens, Greece
| | | | | | | |
Collapse
|
16
|
Magkos F, Manios Y, Babaroutsi E, Sidossis LS. Quantitative ultrasound calcaneus measurements: normative data for the Greek population. Osteoporos Int 2005; 16:280-8. [PMID: 15241583 DOI: 10.1007/s00198-004-1670-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2004] [Accepted: 05/10/2004] [Indexed: 10/26/2022]
Abstract
Quantitative ultrasound (QUS) is a peripheral bone densitometry technique that is rapidly gaining in popularity, and is widely used worldwide for the assessment of skeletal status. This, however, generally occurs in the absence of adequate clinical guidelines. As accurate interpretation of the results and correct classification in individual fracture risk assessment are of great value, the present study was carried out to establish a reference database for calcaneal QUS measurements across age group and gender in Greece. A total of 1205 subjects (821 females and 384 males) from three age groups (409 children, 341 adults and 455 elderly) were recruited. QUS measurements were performed at the heel with the Sahara device, which measures broadband ultrasound attenuation (BUA) and speed of sound (SOS), and then combines these variables into a single parameter, the quantitative ultrasound index (QUI). Overall, gender-related differences were more pronounced among the elderly, while age-related differences were more pronounced among females. Elderly men had higher QUS parameters than women of peer age, but no major gender differences were observed in children and adults. In males, only BUA showed a variation with age, being higher in adult and elderly men compared to boys. On the other hand, all QUS parameters varied significantly with age in females, the general trends being mildly positive from childhood to adulthood, when peak levels were observed, and negative thereafter. The results for the Greek population were in the range reported previously for other populations, but some discrepancies were evident, probably resulting from ethno-specific characteristics and different QUS instrumentation. Importantly, using the manufacturer's or the local database as the reference population for computing T-scores led to significantly different classification of subjects into conventional categories of risk. These data could be useful as a guide for comparing the results of individual studies, as well as for the assessment of Greek men and women at risk of fracture.
Collapse
Affiliation(s)
- Faidon Magkos
- Laboratory of Nutrition and Clinical Dietetics, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Avenue, 17671 Athens, Greece
| | | | | | | |
Collapse
|
17
|
Hernández JL, Marin F, González-Macías J, Díez-Pérez A, Vila J, Giménez S, Galán B, Arenas MS, Suárez F, Gayola L, Guillén G, Sagredo T, Belenguer R, Moron A, Arriaza E. Discriminative capacity of calcaneal quantitative ultrasound and of osteoporosis and fracture risk factors in postmenopausal women with osteoporotic fractures. Calcif Tissue Int 2004; 74:357-65. [PMID: 15255073 DOI: 10.1007/s00223-003-0158-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Bone fragility fractures constitute the principal complication of osteoporosis. The identification of individuals at high risk of sustaining osteoporotic fractures is important for implementing preventive measures. The purpose of this study is to analyze the discriminative capacity of a series of osteoporosis and fracture risk factors, and of calcaneal quantitative ultrasound (QUS), in a population of postmenopausal women with a history of osteoporotic fracture. A cross-sectional analysis was made of a cohort of 5195 women aged 65 or older (mean +/- SD: 72.3 +/- 5.4 years) seen in 58 primary care centers in Spain. A total of 1042 women (20.1%) presented with a history of osteoporotic fracture. Most fractures (93%) were non-vertebral. Age-adjusted odds ratios corresponding to each decrease in one standard deviation of the different QUS parameters ranged from 1.47 to 1.55 (P < 0.001) for fractures. The age-adjusted multivariate analysis yielded the following risk factors independently associated with a history of osteoporotic fracture: number of fertile years, a family history of fracture, falls in the previous year, a history of chronic obstructive airway disease, the use of antiarrhythmic drugs, and a low value for any of the QUS parameters. The area under the receiver operating characteristic curve of the best model was 0.656. In summary, a series of easily assessable osteoporotic fracture risk factors has been identified. QUS was shown to discriminate between women with and without a history of fracture, and constitutes a useful tool for assessing fracture risk. Various of the vertebral and hip fracture risk factors frequently cited in North American and British populations showed no discriminative capacity in our series--thus suggesting that such factors may not be fully applicable to our population and/or to the predominant type of fractures included in the present study.
Collapse
Affiliation(s)
- J L Hernández
- Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Alvarez Mazariegos JA. Osteoporosis y ecografía ósea de calcáneo. Empresas farmacéuticas y atención primaria. ¿Qué estamos haciendo? Aten Primaria 2004; 34:548-52. [PMID: 15607058 PMCID: PMC7676079 DOI: 10.1016/s0212-6567(04)70861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
19
|
Damilakis J, Papadokostakis G, Perisinakis K, Hadjipavlou A, Gourtsoyiannis N. Can radial bone mineral density and quantitative ultrasound measurements reduce the number of women who need axial density skeletal assessment? Osteoporos Int 2003; 14:688-93. [PMID: 12897977 DOI: 10.1007/s00198-003-1420-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2002] [Accepted: 05/02/2003] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to investigate the clinical usefulness of forearm bone mineral density (BMD) and speed of sound (SOS) at the phalanx and radius as pre-selection tests to identify women with low BMD at the axial skeleton. BMD was measured by dual-energy X-ray absorptiometry (DXA) in the forearm, lumbar spine and femoral neck. SOS at the radius and phalanx was measured using a multisite quantitative ultrasound (QUS) device. Measurements were performed on 524 consecutive women referred for the assessment of BMD. Women with a T-score <-1 and T-score < or =-2.5 at either spine or femoral neck were identified, and T-score cut-off values for the forearm DXA and QUS variables were determined. Cut-off values for the forearm BMD estimated to detect normal women and those with T-score <-1 at the axial skeleton identified a total of 82% of subjects with 91% certainty. Cut-off values for the forearm BMD determined to detect women with T-score >-2.5 and those with osteoporosis allowed the identification of 62% of the study population with 90% certainty. Cut-off values for the phalangeal and radial SOS estimated to detect normal women and those with T-score <-1 at the axial skeleton identified a total of 49% and 1% of subjects, respectively. Cut-off values estimated for QUS variables to detect women with T-score >-2.5 and those with osteoporosis at the axial skeleton either failed to detect subjects with sufficient certainty (phalangeal SOS) or detected a negligible percentage of patients (radial SOS). In conclusion, forearm BMD may be used as a pre-selection test to identify women with low BMD at the axial skeleton, thus enabling reduction of the number of women who need axial BMD assessment. SOS of the phalanges and radius appears to have less value in the detection of the women with low axial BMD.
Collapse
Affiliation(s)
- J Damilakis
- Department of Medical Physics, Faculty of Medicine, University of Crete, PO Box 1393, 71409 Iraklion, Crete, Greece.
| | | | | | | | | |
Collapse
|