The relationship between bone mineral density and ultrasound in postmenopausal and osteoporotic women

Abstract

The aim of this cross-sectional study was to use a novel method of data analysis to demonstrate that patients with osteoporosis have significantly lower ultrasound results in the heel after correcting for the effect of bone mineral density (BMD) measured in the spine or hip. Three groups of patients were studied: healthy early postmenopausal women, within 3 years of the menopause (n = 104, 50%), healthy late postmenopausal women, more than 10 years from the menopause (n = 75, 36%), and a group of women with osteoporosis as defined by WHO criteria (n = 30, 14%). Broadband ultrasound attenuation (BUA), speed of sound (SOS) and Stiffness wer measured using a Lunar Achilles heel machine, and BMD of the lumbar spine and left hip was measured using dual-energy X-ray absorptiometry (DXA). SOS, BUA and Stiffness were regressed against lumbar spine BMD and femoral BMD for all three groups combined. The correlation coefficients were in the range 0.52-0.58, in agreement with previously published work. Using a calculated ratio R, analysis of variance demonstrated that the ratio was significantly higher in the osteoporotic group compared with the other two groups. This implied that heel ultrasound values are proportionately lower in the osteoporotic group compared with the other two groups for an equivalent value of lumbar spine and femoral neck BMD. We conclude that postmenopausal bone loss is not associated with different ultrasound values once lumbar spine or femoral neck BMD is taken into account. Ultrasound does not give additional information about patterns of bone loss is postmenopausal patients but is important in those patients with osteoporosis and fractures.

A Comparison of the Longitudinal Changes in Quantitative Ultrasound with Dual-Energy X-ray Absorptiometry: The Four-Year Effects of Hormone Replacement Therapy

“…Calculating the Standardized Precision transforms the precision of SOS to about 3 times that of AP spine BMD. The long-term Standardized Precision for the QUS parameters ranged from 2 to 3 times that of AP spine BMD, which is consistent with the findings of a number of short-term studies [10,18]. This means that for a given rate of change, the long-term Standardized Precision of QUS is 2-3 times that of AP spine DXA, in a given individual.…”

“…This advantage coupled with the fact that measurements are ionizing radiation free, and the machines relatively inexpensive and small enough to be portable, makes it a potentially valuable tool both for fracture risk assessment and for measuring the response to therapy. Currently QUS parameters can distinguish between normal and osteoporotic subjects [9,10] and recent studies have reported that QUS techniques are able to predict hip and vertebral fractures [11][12][13]. However, the usefulness of QUS in long-term monitoring has yet to be defined [14,15].…”

“…Standardized Precision has been defined as the ratio (in a reference population) of the precision in absolute units to the average annual rate of change for that parameter [18]. Short-term studies have shown the Standardized Precision for QUS to be approximately twice that of DXA, but there is little information on long-term precision [10,18].…”

Use of quantitative ultrasonography in differentiating osteomalacia from osteoporosis: preliminary study.

“…KEY WORDS: Bone densitometry; Osteoporosis; Osteomalacia; Densitometry. 0.4 to 0.7 [13][14][15][16][17][18][19][20] and are higher when measurements are performed on the same skeletal site. 21 The purpose of this study was to utilize ultrasonographic techniques to differentiate qualitative alterations of bones with the same mineral content.…”

Ultrasound bone mineral density of os calcis – its relationship with bone mineral markers and 25(OH) vitamin D in endemic flurotic and non-flurotic villages

“…BMD measured by QUS has shown strong relationship with age, gender, body mass index (BMI), waist to hip ratio (WHR), smoking status, frequency of exercise etc. 1 There are studies [11][12][13][14] pointing to limitations of using calcaneal USBMD in screening, monitoring of therapy. Apart from the limitations intrinsic to In both the villages dietary habits, the daily dietary intake of calcium, phosphorus and phytates were documented by recalling the diet consumed in the previous 5 to 7 days.…”