Osteoporosis International

, Volume 18, Issue 6, pp 771–777 | Cite as

Quantitative ultrasound predicts hip and non-spine fracture in men: the MrOS study

  • D. C. Bauer
  • S. K. Ewing
  • J. A. Cauley
  • K. E. Ensrud
  • S. R. Cummings
  • E. S. Orwoll
  • Osteoporotic Fractures in Men (MrOS) Research Group
Original Article



Quantitative ultrasound (QUS) is associated with fracture risk in women, but there are few data in men. We studied 5,607 older men and found that QUS predicts hip and any non-spine fracture risk nearly as well as BMD. Combined measurements of QUS and BMD are not superior to either measurement alone.


Quantitative ultrasound (QUS) predicts fracture risk among older women, but there are few prospective studies among older men. We studied the ability of QUS and BMD measurements to predict hip and other non-spine fractures in a population-based study of older men.


Calcaneal QUS and hip BMD were measured in 5,607 men aged ≥65 years recruited from six US centers. At baseline duplicate QUS measurements with repositioning were obtained, and subsequent hip and other non-spine fractures were documented by review of x-rays or x-ray reports. The relationships between QUS and fractures were examined with proportional hazard models adjusted for age and clinic. We used receiver operating characteristic curves and predicted fracture risk models to determine the utility of QUS alone, BMD alone or the combination of QUS+BMD.


During a mean follow-up of 4.2 years with 99% complete follow-up, 239 men suffered a non-spine fracture, including 49 hip fractures. Each standard deviation reduction in broadband ultrasonic attenuation (BUA) was associated with an increased risk of hip (relative hazard=2.0, CI: 1.5, 2.8) and any non-spine fracture (relative hazard=1.6, CI: 1.4, 1.8). The area under the receiver operating characteristic curve and the predicted probability of fracture were similar for BUA alone, BMD alone and the combination of BUA+BMD, indicating that once BUA or BMD is known, the other measurement does not add useful information. Other QUS parameters gave similar results.


QUS measurements predict the risk of hip and any non-spine fracture in older men, and do so nearly as well as hip BMD measurements. Combined measurements of QUS and BMD are not superior to either measurement alone.


BMD Broadband ultrasonic attenuation Cohort Fracture Quantitative ultrasound 


Conflict of interest statement

None of the authors have any conflict of interest.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • D. C. Bauer
    • 1
    • 2
  • S. K. Ewing
    • 2
  • J. A. Cauley
    • 3
  • K. E. Ensrud
    • 4
  • S. R. Cummings
    • 1
  • E. S. Orwoll
    • 5
  • Osteoporotic Fractures in Men (MrOS) Research Group
  1. 1.UCSFSan FranciscoUSA
  2. 2.University of CaliforniaSan FranciscoUSA
  3. 3.University of PittsburghPittsburghUSA
  4. 4.University of MinnesotaMinneapolisUSA
  5. 5.Oregon Health Sciences UniversityPortlandUSA

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