Osteoporosis International

, Volume 23, Issue 3, pp 1001–1006

Predictive values of calcaneal quantitative ultrasound and dual energy X ray absorptiometry for non-vertebral fracture in older men: results from the MrOS study (Hong Kong)

  • T. Kwok
  • C. C. Khoo
  • J. Leung
  • A. Kwok
  • L. Qin
  • J. Woo
  • P. C. Leung
Original Article

DOI: 10.1007/s00198-011-1634-x

Cite this article as:
Kwok, T., Khoo, C.C., Leung, J. et al. Osteoporos Int (2012) 23: 1001. doi:10.1007/s00198-011-1634-x

Abstract

Summary

Calcaneal QUS is comparable to DXA in predicting non-vertebral fractures in older Chinese men.

Introduction

The predictive values of calcaneal quantitative ultrasound (QUS) and dual-energy X-ray absorptiometry (DXA) for non-vertebral fractures in older Chinese men were examined.

Methods

One thousand nine hundred twenty-one Chinese men aged 65–92 years had calcaneal QUS and axial DXA bone mineral density (BMD) measurements. The incidence of non-vertebral fractures was documented. Cox regression and receiver operating curve (ROC) analysis were used to examine the associations of QUS parameters and BMD with the incidence of non-vertebral fractures.

Results

The duration of follow-up was (mean±SD) 6.5 ± 1.7 years. One hundred thirty-one non-vertebral fractures were recorded, 71 of which were major fragility fractures. Broadband ultrasound attenuation (BUA) and quantitative ultrasound index (QUI) were significantly associated with non-vertebral fractures and major fragility fractures, with age and fracture history-adjusted hazard ratio (95% CI) of 1.23 (1.03, 1.47) and 1.32 (1.10, 1.59) per standard deviation reduction, respectively, for non-vertebral fractures; 1.32 (1.04, 1.68) and 1.43 (1.11, 1.84), respectively, for major fragility fractures. Age and fracture history-adjusted areas under ROC curves of hip or spine BMDs were significantly greater than that of BUA or QUI in predicting major fragility fractures, but not in predicting all non-vertebral fractures. The addition of BUA or QUI had no effect on AUCs of total hip BMD alone.

Conclusions

The ability of calcaneal QUS to predict non-vertebral fractures was comparable to that of axial BMD by DXA, but was inferior to BMD in predicting major fragility fractures in older Chinese men.

Keywords

Asian continental ancestry group Bone density Cohort study Fracture Male Quantitative ultrasound 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • T. Kwok
    • 1
  • C. C. Khoo
    • 1
  • J. Leung
    • 2
  • A. Kwok
    • 2
  • L. Qin
    • 3
  • J. Woo
    • 1
  • P. C. Leung
    • 2
  1. 1.Department of Medicine and TherapeuticsPrince of Wales Hospital, The Chinese University of Hong KongHong KongChina
  2. 2.CUHK Jockey Club Centre for Osteoporosis Care and Control, School of Public HealthThe Chinese University of Hong KongHong KongChina
  3. 3.Department of Orthopaedics and TraumatologyPrince of Wales Hospital, The Chinese University of Hong KongHong KongChina

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