Quantitative Heel Ultrasonography, 25-Hydroxyvitamin D, and Urine Amino-terminal Cross-linking Telopeptide of Type I Collagen in Patients With a Recent Hip Fracture

Abstract

Objective This study examined heel ultrasonography, levels of 25-OHD, and levels of urinary NTX-I in patients with a recent osteoporotic hip fracture to see if they were clinically useful. Methods T scores of stiffness index(SI) obtained from quantitative heel ultrasound(QUS), levels of serum 25-hydroxyvitamin D(25-OHD) and levels of urine N-terminal cross linking telopeptide of type I collagen(NTX-I) were obtained in 53 female and 32 male hip fracture patients. Sixty five female patients and five male patients attending our geriatric clinic were used for comparison. Results The T scores of SI of the hip fracture patients were less than those of the geriatric clinic patients. The difference was signficant in females(p = 0.0001), but not in males (p = 0.1). Serum levels of 25-OHD were less than 28 ng/ml in 50 out of 59 patients, and less than 5 ng/ml in two patients. Levels of urinary NTX-I were variable, and were not correlated with other parameters. Conclusions Patients who have sustained a hip fracture have a low SI determined by QUS; this is easy to perform and it provides a baseline T score from which to assess treatment effects. The majority of these patients are vitamin D deficient and measurement of the level of 25-OHD would enable physicians to prescribe an appropriate dose of vitamin D. Urine NTX-I measured shortly after a hip fracture is not clinically helpful.

Discriminative Ability of Heel Quantitative Ultrasound in Postmenopausal Women with Prevalent Vertebral Fractures: Application of Optimal Threshold Cutoff Values Using Classification and Regression Tree Models

“…Those women who had sustained a vertebral fracture had lower values for every DXA and QUS measurement, as shown in Table 3. This finding has previously been described in several studies, not only in vertebral fractures but also in wrist and hip fractures [5,[7][8][9][10][11][12][22][23][24]; and it was not the aim of our study. Our real objective was to obtain a QUS value which would allow us to avoid the necessity of performing DXA in women at risk for vertebral fracture using the CART models.…”