Abstract
Purpose
This study was undertaken to compare the quantitative ultrasound (QUS) parameters of amplitudedependent speed of sound (AD-SoS) and ultrasound bone profile index (UBPI) of the phalanges with bone mineral density (BMD) of the lumbar spine and proximal hip using dual-energy X-ray absorptiometry (DXA) in discriminating women with vertebral fracture.
Materials and methods
A total of 692 postmenopausal Caucasian women were included in the study. The presence of vertebral fracture was evaluated by radiography. AD-SoS and UBPI were measured at the phalangeal metaphysis using a DBM Sonic device. Multiple logistic regression analysis was performed to estimate the odds ratio (OR) for vertebral fractures. The ORs were also adjusted for the significant anthropometric variables of age, weight and height. Furthermore, for QUS parameters, the ORs were also adjusted for lumbar spine and total hip BMD.
Results
All measurements obtained with DXA and QUS significantly discriminated between women with and without fractures (p<0.0001). However, the OR was higher for lumbar spine BMD (OR 4.01), AD-SoS (OR 3.81), total hip (OR 3.7) and femoral neck BMD (OR 3.62).
Conclusions
The QUS parameter AD-SoS showed diagnostic sensitivity equal to that of lumbar DXA in discriminating between women with and without osteoporotic vertebral fractures.
Riassunto
Obiettivo
Confronto fra i parametri ultrasonografici quantitativi (QUS) amplitude dependent speed of sound (AD-SoS) e ultrasound bone profile index (UBPI) a livello delle falangi della mano con la densità minerale ossea (BMD) alla colonna lombare e al femore prossimale mediante tecnica dual energy X-ray absorptiometry (DXA) nel discriminare le fratture vertebrali.
Materiali e metodi
Sono state incluse 692 donne in post-menopausa. La presenza di fratture vertebrali è stata documentata radiograficamente. AD-SoS e UBPI sono stati misurati alla metafisi delle falangi della mano utilizzando il DBM Sonic. L’analisi logistica è stata utilizzata per determinare il rischio relativo di frattura vertebrale (odds rario, OR). OR è stato altresì aggiustato per variabili antropometriche significative: età, peso e altezza. Inoltre per i parametri QUS, OR è stato aggiustato anche per la BMD lombare e femorale.
Risultati
Nel modello logistico DXA e QUS discriminano significativamente fra donne con e senza fratture vertebrali (p<0,0001). L’OR è risultato più alto per la BMD lombare (OR 4,01), AD-SoS (OR 3,81), femore totale (OR 3,7) e collo femorale (OR 3,62).
Conclusioni
Il parametro AD-SoS ha dimostrato una sensibilità diagnostica uguale a quella della scansione lombare DXA nel discriminare tra donne non fratturate e donne con fratture vertebrali da osteoporosi.
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Albanese, C.V., De Terlizzi, F. & Passariello, R. Quantitative ultrasound of the phalanges and DXA of the lumbar spine and proximal femur in evaluating the risk of osteoporotic vertebral fracture in postmenopausal women. Radiol med 116, 92–101 (2011). https://doi.org/10.1007/s11547-010-0577-1
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DOI: https://doi.org/10.1007/s11547-010-0577-1