ULTRASOUND PARAMETERS IN OSTEOPOROTIC PATIENTS TREATED WITH SALMON-CALCITONIN - A LONGITUDINAL-STUDY

Speed of sound (SOS) and broadband ultrasound attenuation (BUA) of ult rasound (US) in bone have been proposed as alternatives to radiation-b ased methods for the quantitative assessment of osteoporosis. However, the usefulness of US in monitoring response to treatment in osteoporo tic patients has yet to be defined. To compare US with bone mineral de nsity (BMD), we studied 112 osteoporotic women (age range 50-64 years) . Seventy-eight of them were treated with salmon calcitonin nasal spra y (CT; 200 IU/day, 1 month on and 1 month off) and calcium (500 mg/day ); 34 patients were given only calcium. One hundred and four women com plied with treatment throughout the 2-year study period. At baseline a nd after 1 and 2 years we measured BMD at lumbar spine by dual-energy X-ray absorptiometry (DXA), and SOS, BUA and Stiffness index, by an Ac hilles ultrasound unit. Moreover, biochemical markers of bone turnover (alkaline phosphatase, osteocalcin and hydroxyproline) were also meas ured at baseline and after 6, 12 and 24 months. In the calcitonin-trea ted group at the end of the study period BMD had increased by 1.99%, S OS by 0.20%, BUA by 0.88% and Stiffness by 2.12%. By contrast in the c alcium-treated group all parameters had decreased (BMD, -2.66%; SOS, - 0.55%; BUA, -3.30%; Stiffness, -6.0%) by the end of the study period. The differences between groups were significant for BMD, SOS and Stiff ness. At baseline a significant, but weak correlation was found betwee n BMD and US parameters. The correlation coefficients between percenta ge changes at the end of the study period, in BMD and in SOS, BUA and Stiffness, were all significant (p<0.001), being 0.41, 0.53 and 0.57 r espectively. In conclusion, ultrasound measurements carried out in con junction with BMD measurements will yield a more comprehensive assessm ent of skeletal status and may be helpful in monitoring the response t o treatment in osteoporotic patients.