Comparison of Three Bone Ultrasounds for the Discrimination of Subjects With and Without Osteoporotic Fractures Among 7562 Elderly Women

Abstract

Bone ultrasound measures (QUSs) can assess fracture risk in the elderly. We compared three QUSs and their association with nonvertebral fracture history in 7562 Swiss women 70 -80 years of age. The association between nonvertebral fracture was higher for heel than phalangeal QUS.Introduction: Because of the high morbidity and mortality associated with osteoporotic fractures, it is essential to detect subjects at risk for such fractures with screening methods. Because quantitative bone ultrasound (QUS) discriminated subjects with osteoporotic fractures from controls in several cross-sectional studies and predicted fractures in prospective studies, QUS could be more practical than DXA for screening. Material and Methods:This cross-sectional and retrospective multicenter (10 centers) study was performed to compare three QUSs (two heel ultrasounds: Achillesϩ [GE-Lunar] and Sahara [Hologic]; the phalanges: ultrasound DBM sonic 1200 [IGEA]) for determining by logistic regression nonvertebral fracture odds ratio (OR) in a sample of 7562 Swiss women, 75.3 Ϯ 3.1 years of age. The two heel QUSs measured the broadband ultrasound attenuation (BUA) and the speed of sound (SOS). In addition, Achillesϩ calculated the stiffness index (SI) and the Sahara calculated the quantitative ultrasound index (QUI) from BUA and SOS. The DBM sonic 1200 measured the amplitude-dependent SOS (AD-SOS). Results: Eighty-six women had a history of atraumatic hip fracture after the age of 50, 1594 had a history of forearm fracture, and 2016 had other nonvertebral fractures. No fracture history was reported by 3866 women. Discrimination for hip fracture was higher than for the other nonvertebral fractures. The two heel QUSs had a significantly higher discrimination power than the QUSs of the phalanges, with standardized ORs, adjusted for age and body mass index, ranging from 2.1 to 2.7 (95% CI ϭ 1.6, 3.5) compared with 1.4 (95% CI ϭ 1.1, 1.7) for the AD-SOS of DBM sonic 1200. Conclusion: This study showed a high association between heel QUS and hip fracture history in elderly Swiss women. This could justify integration of QUS among screening strategies for identifying elderly women at risk for osteoporotic fractures.

Ultrasound Assessment of Bone Mass in Central Africans Population

“…It was superimposable to those of other populations in the world (Aspray et al, 1996;Joly et al, 1999;Hartl et al, 2002;Krieg et al, 2003;Vanderjagt et al, 2001;Gonç alves et al, 2015) and influenced in the same order by the anthropo-biometric elements and the hormonal (menopausal) status. These result are similar to those of bone mass measured by radiogrammetry, bone mineral content and mineral density measured by DXA on other sites and several populations (WHO Study Group, 1994;Aspray et al, 1996;Gonç alves et al, 2015;Barkmann et al, 2002;Baroncelli et al, 2009;Dequeker et al, 1982).…”

“…Skeletal status has been evaluated in several studies with the use of phalangeal QUS measurements (Joly et al, 1999;Hartl et al, 2002;Krieg et al, 2003;Vanderjagt et al, 2001;Gonç alves et al, 2015;Hodson et al, 2003;Drozdzowska et al, 2003;Ribeiro et al, 2010;Barkmann et al, 2002;Dib et al, 2005;Moayyeri et al, 2012;Wuster et al, 2000). However, the majority of them was done in Caucasians subjects and assessed usefulness of QUS at the hand phalanges to detect patients with osteoporosis.…”

“…Although the real significance of the measured parameters are still in study, ultrasonic methods have attracted increasing interest due to its advantages related above and seems to be an interesting tool for low-income countries (WHO Study Group, 1994;Hartl et al, 2002;Krieg et al, 2003;Vanderjagt et al, 2001;Gonç alves et al, 2015).…”

“…Phalangeal ultrasound Osteodensitometry is an increasingly accepted exploration by osteoporosis clinicians (Joly et al, 1999;Hartl et al, 2002;Krieg et al, 2003;Vanderjagt et al, 2001;Gonç alves et al, 2015), but it is not yet fully validated by WHO and most studies done to provide normative data for the QUS parameters, such as Amplitude Dependent Speed of Sound (AD-SoS), were based on European Caucasians samples.…”

Tibial or hip BMD predict clinical fracture risk equally well: results from a prospective study in 700 elderly Swiss women

“…In a predefined cohort of elderly (70 to 80 years old) women who were included in the previously published prospective, multi-centre Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture risk (SEMOF) study [5], BMD was measured using DXA. Women were randomly recruited from official state registries between January 1998 and April 2000 and were included in SEMOF if able to walk and being independent for their daily activities.…”