[Quantitative ultrasound for the diagnosis of osteoporosis]

Sex hormones and quantitative ultrasound parameters at the heel in men and women from the general population

Purpose/introduction

The present study investigates potential associations between liquid chromatography-mass spectrometry (LC-MS) measured sex hormones, dehydroepiandrosterone sulphate, sex hormone-binding globulin (SHBG) and bone ultrasound parameters at the heel in men and women from the general population.

Methods

Data from 502 women and 425 men from the population-based Study of Health in Pomerania (SHIP-TREND) were used. Cross-sectional associations of sex hormones including testosterone (TT), calculated free testosterone (FT), dehydroepiandrosterone sulphate (DHEAS), androstenedione (ASD), estrone (E1) and SHBG with quantitative ultrasound (QUS) parameters at the heel, including broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI) were examined by analysis of variance (ANOVA) and multivariable quantile regression models.

Results

Multivariable regression analysis showed a sex-specific inverse association of DHEAS with SI in men (Beta per SI unit = − 3.08, standard error (SE) = 0.88), but not in women (Beta = − 0.01, SE = 2.09). Furthermore, FT was positively associated with BUA in men (Beta per BUA unit = 29.0, SE = 10.1). None of the other sex hormones (ASD, E1) or SHBG was associated with QUS parameters after multivariable adjustment.

Conclusions

This cross-sectional population-based study revealed independent associations of DHEAS and FT with QUS parameters in men, suggesting a potential influence on male bone metabolism. The predictive role of DHEAS and FT as a marker for osteoporosis in men warrants further investigation in clinical trials and large-scale observational studies.

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Population-based data of healthy men and women from the general population

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Sex hormone panel measured by liquid chromatography-mass spectrometry (LC-MS)

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Associations of dehydroepiandrosterone sulphate and free testosterone with bone ultrasound parameters in men

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Estrone, androstenedione and SHBG were not associated with bone ultrasound parameters in both sexes.

Osteoporosis among household women: A growing but neglected phenomenon

Background

Osteoporosis is associated with variable morbidity and socio-economic burden and referred as a "silent epidemic" with increasing risk among Indian women. The present study was conducted to find prevalence of osteoporosis.

Methods

A descriptive cross-sectional study was conducted in Ranchi city with household women as participants. Data was collected by means of pre-tested structured questionnaire in Hindi language and bone status was screened utilizing calcaneal quantitative ultrasound as a diagnostic tool to estimate bone mineral density from 223 participants and statistical analysis was performed with SPSS software.

Results

The mean age of the participants was 37.9 (5.63) and majority (52.5%) of them were vegetarian. The prevalence of osteoporosis was 8.5% (5.2-13%) while 45.7% (39-52.5%) had osteopenia. We found no significant association of osteoporosis and osteopenia with income, physical activity, and dietary patterns on univariate analysis. There was no statistical significant difference between mean age and BMI of participant among normal, osteoporosis, and osteopenia participant (p value >0.5). Multivariate logistic regression analysis shows that 20% increase chances of risk with five years increase in age, the protective effect of physical activity (22%) and non-vegetarian diet (18%) though not statistically significant.

Conclusion

This study shows that significant number of women had osteopenia/osteoporosis within 35-40 years age group. Intensive information, education, and communication activities with regard to osteoporosis causative factors and preventive measures targeted to household women may play an important role, if started at young age.

Cross sectional study of osteoporosis among women

Osteoporosis is a major public health problem, associated with substantial morbidity and socio-economic burden. An early detection can help in reducing the fracture rates and overall socio-economic burden. The present study was carried out to screen the bone status (osteopenia and osteoporosis) above the age of 35 yrs in the women. A community based cross sectional study was carried out in 158 women by calculating WHO T-scores utilizing calcaneal QUS as diagnostic tool. The prevalence of osteoporosis and osteopenia was found to be 13.3% ± 5.29% and 48.1% ± 7.79% respectively. Statistical association of prevalence of osteopenia and osteoporosis was found to be significant with age group; gravida status; attainment of menopause; body weight and physically active status of the women. The statistical association was not significant in relation to the rank status of their husband, as well as dietary pattern of the women but still it has to be substantiated by conducting larger community based trials in future. The present study found that there was statistically significant relationship between age group and the prevalence of osteopenia and osteoporosis. There was a negative correlation between age of the women and BMD. Besides age, gravida status and menopausal status have negative correlation with BMD while positive correlation with physically active lifestyle. The results were found to be non-significant in relation to rank status of husband and dietary pattern.

Neue Techniken in der Osteoporosediagnostik

In this review article current developments and applications in quantitative osteoporosis imaging are presented. Developments in the field of DXA include geometrical parameters of the proximal femur such as the "hip axis length" and new ROIs to determine BMD. Advances in QCT are new volumetric techniques to quantify BMD at the lumbar spine and the proximal femur. In addition techniques to determine BMD in standard contrast-enhanced abdominal computed tomography studies are described. Currently with the new bone quality concept in full bloom techniques to quantify trabecular bone architecture as new surrogates of bone strength are of increasing significance. Spatial high-resolution techniques such as magnetic resonance imaging and new computed tomography techniques have shown their potential in assessing trabecular bone structure. In addition ultrasound is considered a low-cost technique to explore bone quality.