Prediction of Hip Fracture Risk by Quantitative Ultrasound in More Than 7000 Swiss Women ≥70 Years of Age: Comparison of Three Technologically Different Bone Ultrasound Devices in the SEMOF Study

Krieg, Marc‐Antoine; Cornuz, Jacques; Ruffieux, Christiane; Melle, Guy van; Büche, Daniel; Ma, Dambacher; Hans, Didier; Hartl, Florian; Häuselmann, H. J.; Kraenzlin, Marius E.; Lippuner, Kurt; Neff, M.; Pancaldi, P.; Rizzoli, René; Tanzi, Franco; Theiler, Robert; Tyndall, Alan; Wimpfheimer, C; Burckhardt, P.

doi:10.1359/jbmr.060615

Cited by 95 publications

(68 citation statements)

References 28 publications

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“…In agreement with data from the literature (Ensrud et al, 1995;Krieg et al, 2006), using both devices very low values were detected (Table 1A), without any significant difference between fractured and non-fractured centenarians (Table 1B).…”

Section: Bone Metabolism In Centenarianssupporting

confidence: 91%

Calcium metabolism and vitamin D in the extreme longevity

Passeri

Vescovini

Sansoni

et al. 2008

Experimental Gerontology

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Skeletal remodelling is a continuous process during life and is still active also in extreme senescence. In the elderly, bone resorption often prevails over bone formation, causing bone loss and fragility. Elderly subjects are exposed to the risk of fractures, and loss of self-sufficiency, if considering that the proximal femur is the most frequently involved site. Bone remodelling can maintain circulating calcium within physiological ranges, at the expense of a substantial loss of this ion from the skeleton, particularly during senescence. Calcium metabolism is regulated at cellular/molecular level by a network of cytokines, growth factors, systemic hormones that act on bone in paracrine/autocrine/ systemic fashion. Among the molecules involved in bone metabolism, parathyroid hormone (PTH) and vitamin D present some peculiar aspects during senescence. The osteometabolic features in a consistent group of centenarians have been evaluated. It results that a severe hypovitaminosis D was present in 99 out of 104 centenarians (25-OH vitamin D below 5 nmol/L), and that it plays an important role as a factor inducing a vicious circle involving hypocalcemia, secondary hyperparathyroidism, together with biochemical features indicating a consistent bone loss. Serum C-terminal cross-linking telopeptide, a specific marker of bone resorption was elevated in 92% of these subjects. Moreover, it has been found that several femoral fractures had occurred after 90 years of age. These data offer a rational for the possible prevention of elevated bone turnover, bone loss and consequently the reduction of osteoporotic fractures and fractures-induced disability, in the oldest olds, through the simple supplementation with calcium and vitamin D.

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Section: Bone Metabolism In Centenarianssupporting

confidence: 91%

Calcium metabolism and vitamin D in the extreme longevity

Passeri

Vescovini

Sansoni

et al. 2008

Experimental Gerontology

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“…[15][16][17][18][19][20][21][22] Measurements of bone are complicated by many factors associated with their inhomogeneous character and irregular shapes, making it difficult to sort out potential physical mechanisms underlying phase aberration artifacts. In vitro studies of calcaneus bone samples by Wear 6 and Strelitizki et al 3 and studies in human subjects by Wear 4 and Petley et al 2 appear to indicate that phase insensitive processing of array data yields improved estimates of the true ultrasonic attenuation.…”

Section: Introductionmentioning

confidence: 99%

Bone sonometry: Reducing phase aberration to improve estimates of broadband ultrasonic attenuation

Bauer

Anderson

Holland

et al. 2009

The Journal of the Acoustical Society of America

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Previous studies suggest that phase cancellation at the receiving transducer can result in the overestimation of the frequency dependent ultrasonic attenuation of bone, a quantity that has been shown to correlate with bone mineral density and ultimately with osteoporotic fracture risk. Evidence supporting this interpretation is provided by phase insensitive processing of the data, which appear to reduce the apparent overestimates of attenuation. The present study was designed to clarify the components underlying phase aberration artifacts in such through-transmission measurements by conducting systematic studies of the simplest possible test objects capable of introducing phase aberration. Experimental results are presented for a Lexan phantom over the frequency range 300-700 kHz and a Plexiglas phantom over the 3 -7 MHz range. Both phantoms were flat and parallel plates featuring a step discontinuity milled into one of their initially flat sides. The through-transmitted signals were received by a 0.6 mm diameter membrane hydrophone that was raster scanned over a grid coaxial with the transmitting transducer. Signals received by the pseudoarray were processed offline to emulate phase sensitive and phase insensitive receivers with different aperture diameters. The data processed phase sensitively were focused to demonstrate the results of planar, geometrical, and correlation-based aberration correction methods. Results are presented illustrating the relative roles of interference in the ultrasonic field and phase cancellation at the receiving transducer in producing phase aberration artifacts. It was found that artifacts due to phase cancellation or interference can only be minimized with phase insensitive summation techniques by choosing an appropriately large receiving aperture. Data also suggest the potentially confounding role of time-and frequency-domain artifacts on ultrasonic measurements and illustrate the advantages of two-dimensional receiving arrays in determining the slope of attenuation ͑nBUA͒ for the clinical assessment of osteoporosis.

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“…Khaw [7]. In the Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk (SEMOF) study of 7,609 women (mean age 75.2 years) and the Epidemiology of Osteoporosis (EPIDOS) study of 5,662 elderly women (mean age 80.4 years), each decrease of one standard deviation in calcaneal QUS variables corresponded to an approximately 2-fold increase in the hip fracture risk, suggesting that calcaneal QUS was useful for predicting hip fracture risk [8,9].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of quantitative ultrasound parameters in the diagnosis of osteoporosis

et al. 2010

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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.

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Prediction of Hip Fracture Risk by Quantitative Ultrasound in More Than 7000 Swiss Women ≥70 Years of Age: Comparison of Three Technologically Different Bone Ultrasound Devices in the SEMOF Study

Cited by 95 publications

References 28 publications

Calcium metabolism and vitamin D in the extreme longevity

Calcium metabolism and vitamin D in the extreme longevity

Bone sonometry: Reducing phase aberration to improve estimates of broadband ultrasonic attenuation

Accuracy of quantitative ultrasound parameters in the diagnosis of osteoporosis

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