Quantitative ultrasound and symptomatic vertebral fracture risk in Chinesewomen

Quantitative ultrasound (QUS) is emerging as a simple, inexpensive and noni nvasive method for assessing bone quality and assessing fracture risk. We a ssessed the usefulness of a contact calcaneal ultra-sonometer by studying n ormal premenopausal women (group I, n = 53), normal postmenopausal women (g roup II, n = 198), and osteoporotic women without (group III, It = 141) and with vertebral fractures (group IV, n = 53). The osteoporotic subjects had a T-score of the spine or hip neck bone mineral density (BMD) <-2.5 based on the local Chinese peak young mean values. When compared with postmenopau sal controls, mean broadband ultrasound attenuation (BUA), speed of sound ( SOS), and quantitative ultrasound index (QUI) were 26%, 2.1% and 25% lower in women with vertebral fractures (p all <0.005). The correlation coefficie nts between QUS parameters and BMD of the spine and hip ranged between 0.4 and 0.5. The ability of the QUS to discriminate between patients groups was determined based on the mean value of normal premenopausal women in group I. The mean T-score for women with fractures was -2.87 +/- 1.02 for BUA, -2 .54 +/- 0.79 for SOS, -3.17 +/- 0.70 for QUI, -2.65 +/- 0.86 for L2-4 BMD a nd -2.53 +/- 0.66 for hip neck BMD. After adjustment for age and body mass index, the odds ratio of vertebral fracture was 1.71 (95% CI 1.2-2.6) for e ach 1 SD reduction in BUA, 2.72 (1.3-5.3) for SOS, 2.58 (1.4-4.6) for QUI, 2.33 (1.6-3.3) for L2-4 BMD, 2.09 (1.37-3.20) for femoral neck BMD and 1.88 (1.34-2.92) for total hip BMD. The association between the QUS parameters and vertebral fracture risk persisted even adjustment for BMD, The area und er the receiver operating characteristic curve for BUA for vertebral fractu re was 0.92, for SOS, QUI, L2-4 BMD and femoral neck BMD was 0.95, and for total hip was 0.91.