In order to evaluate the usefulness of QUS at the phalanx in the diagnosis
of osteoporosis and in the prediction of fracture risk in males, we studied
182 subjects (age 61.2 +/- 9.4 yr), of which 22 had had a previous nontrau
matic bone fracture. In all subjects, bone mineral density (BMD) at the lum
bar spine and femur was measured by dual X-ray absorptiometry (DXA). Moreov
er, QUS parameters [amplitude-dependent speed of sound (AD-SOS), fast-wave
amplitude, signal dynamic, and bone transmission time (BTT)] were assessed
at the phalanxes using the DBM Sonic 1200 (IGEA). According to World Health
Organization (WHO) criteria, all the patients were divided into two groups
: 62 osteoporotic and 120 nonosteoporotic. All QUS parameters were signific
antly lower in osteoporotic than in nonosteoporotic patients. Receiver oper
ating characteristic (ROC) analysis showed a moderate ability of AD-SOS, BT
T, and ultrasound bone profile index (UBPI) in distinguishing, between heal
thy and osteoporotic men. Among osteoporotic patients, BMD values were lowe
r in patients with fracture than in those without fracture. AD-SOS and BTT
were significantly reduced in men with fracture, Furthermore, in a regressi
on analysis, only BTT and DXA parameters were predictive of fracture. Moreo
ver, performing a multivariate regression analysis BTT entered before BMD a
t the lumbar spine and at Ward's triangle. In conclusion, our data show tha
t QUS parameters are reduced in osteoporotic males; however, only BTT was c
omparable to DXA parameters in the prediction of fracture risk in men.