Correlates of Quantitative Ultrasound in the Women's Healthy Lifestyle Project

Abstract

Quantitative ultrasound (QUS) assessment of bone is a strong predictor of hip fractures and is currently an FDA-approved tool to identify women at risk of osteoporosis. However, few studies have investigated the lifestyle and genetic correlates of QUS in women. This study investigated the cross-sectional associates of several lifestyle, demographic and genetic factors with calcaneal QUS parameters (broadband ultrasound attenuation (BUA) and speed of sound (SOS)) in 393 women aged 45-53 years. Leisure-time and historical physical activity, dietary calcium and protein, body composition, vitamin D receptor genotypes, menopause status, other health behaviors, calcaneal QUS parameters and bone mineral density (BMD) were assessed at a single clinic visit. Lean mass, recent physical activity and African-American race were the strongest correlates of SOS whereas dietary protein, calcium and recent physical activity were the strongest correlates of BUA. These predictors explained 13% and 6% of the variance in SOS and BUA, respectively. Smoking, alcohol intake, education, hormone replacement therapy, calcium and vitamin D supplements, historical physical activity and vitamin D receptor genotypes were not significantly associated with BUA or SOS. Lean body mass and premenopausal status were the strongest correlates of lumbar BMD whereas lean body mass, physical activity, African-American race and body mass index were significantly related to femoral neck BMD. Physical activity remained predictive of SOS after controlling for lumbar BMD. The spectrum and magnitude of risk factors for SOS and BUA, including lean body mass, physical activity, race, protein and calcium intake, parallel previously observed predictors of BMD.

Longitudinal changes in bone health as assessed by the speed of sound in very low birth weight preterm infants

“…13,14,15 Preliminary studies 16,17,18,19 suggest that this technique may be a useful method of assessing changes in bone health in preterm infants, and based on this hypothesis we followed longitudinally a cohort of VLBW infants and investigated the relationship between markers of OP and clinical illness and SOS.…”

Quantitative ultrasound in relation to risk factors for low bone mineral density in South African pre-menopausal women

“…QUS studies on pre- and post-menopausal European [35, 36] and Asian women [37] have shown an increase of both SOS and BUA up to fourth decade followed by a significant decrease after 45 years. Other studies of pre-menopausal women have not consistently reflected changes in QUS with age [13]. This may be due to the relative stability of bone mass prior to menopause as it is generally accepted that the rapid age-related loss of bone with accompanying osteopenia is most apparent in the immediate post-menopausal phase [38].…”

“…BMI has been found to be consistently associated with bone mineral measurements by DXA [5], but QUS associations with BMI have not been as consistent. Positive associations of BUA and SOS with BMI have been demonstrated in different pre-menopausal populations including European women [9, 12], Arabian women [39], and white and African-American women [13, 38]. However, the multicenter European OPUS study [40], the ESOPO study of Italian women [35], and studies of Turkish women [18] did not find a significant association of QUS measures with BMI.…”

Quantitative Ultrasound of the Calcaneus and Falls Risk in the Institutionalized Elderly: Sex Differences and Relationship to Vitamin D Status

“…However, the relationship of QUS measures and 25(OH)D is not as clear. Evidence suggests that neither vitamin D supplementation nor vitamin D receptor genotypes are associated with BUA or VOS measures in perimenopausal women [25]. It is considered that low 25(OH)D levels increase fracture risk [26], but perhaps this effect is not solely through changes in bone mass.…”