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The relationship between bone mineral density and ultrasound in postmenopausal and osteoporotic women

Abstract

The aim of this cross-sectional study was to use a novel method of data analysis to demonstrate that patients with osteoporosis have significantly lower ultrasound results in the heel after correcting for the effect of bone mineral density (BMD) measured in the spine or hip. Three groups of patients were studied: healthy early postmenopausal women, within 3 years of the menopause (n=104, 50%), healthy late postmenopausal women, more than 10 years from the menopause (n=75, 36%), and a group of women with osteoporosis as defined by WHO criteria (n=30, 14%). Broadband ultrasound attenuation (BUA), speed of sound (SOS) and Stiffness were measured using a Lunar Achilles heel machine, and BMD of the lumbar spine and left hip was measured using dual-energy X-ray absorptiometry (DXA). SOS, BUA and Stiffness were regressed against lumbar spine BMD and femoral BMD for all three groups combined. The correlation coefficients were in the range 0.52–0.58, in agreement with previously published work. Using a calculated ratio R, analysis of variance demonstrated that the ratio was significantly higher in the osteoporotic group compared with the other two groups. This implied that heel ultrasound values are proportionately lower in the osteoporotic group compared with the other two groups for an equivalent value of lumbar spine and femoral neck BMD. We conclude that postmenopausal bone loss is not associated with different ultasound values once lumbar spine or femoral neck BMD is taken into account. Ultrasound does not give additional information about patterns of bone loss in postmenopausal patients but is important in those patients with osteoporosis and fractures.

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References

  1. Cummings SR, Black DM, Nevitt MC, et al. Bone density at various sites for prediction of hip fractures: the study of osteoporotic fractures research group. Lancet 1993;341:72–5.

    PubMed  Article  CAS  Google Scholar 

  2. Glüer C-C, Wu CY, Jergas M, Goldstein SA, Genant HK. Three quantitative ultrasound parameters reflect bone structure. Calcif Tissue Int 1994;55:46–52.

    PubMed  Article  Google Scholar 

  3. Genant HK, Engelke K, Fuerst T, et al. Noninvasive assessment of bone mineral and structure: state of the art. J Bone Miner Res 1996;11:707–30.

    PubMed  CAS  Google Scholar 

  4. Porter RW, Miller CG, Grainger D, Palmer SB. Prediction of hip fractures in elderly women: a prospective study. BMJ 1990;301:538–41.

    Google Scholar 

  5. Hans D, Dargent-Molina P, Schott AM, et al. Ultrasonographic heel measurements to predict hip fracture in elderly women: the EPIDOS prospective study. Lancet 1996;348:511–4.

    PubMed  Article  CAS  Google Scholar 

  6. Gonnelli S, Cepollaro C, Agnusdei D, Palmieri R, Rossi S, Gennari C, Diagnostic value of ultrasound analysis and bone densitometry as predictors of vertebral deformity in postmenopausal women. Osteoporos Int 1995;5:413–8.

    PubMed  Article  CAS  Google Scholar 

  7. Graafmans WC, van Lingen A, Ooms ME, Bezemer PD, Lips P. Ultrasound measurements in the calcaneus: precision and its relation with bone mineral density of the heel, hip, and lumbar spine. Bone 1996;19:97–100.

    PubMed  Article  CAS  Google Scholar 

  8. Scott AM, Weill-Engerer S, Hans D, Duboeuf F, Delmas PD, Meunier PJ. Ultrasound discriminates patients with hip fracture equally well as dual energy x-ray absorptiometry and independently of bone mineral density. J Bone Miner Res 1995;10:243–9.

    Google Scholar 

  9. Baran DT, McCarthy CK, Leahey D, Lew R. Broadband ultrasound attenuation of the calcaneus predicts lumbar and femoral neck density in Caucasian women: a preliminary study. Osteoporos Int 1991;1:110–3.

    PubMed  Article  CAS  Google Scholar 

  10. Schott AM, Hans D, Garnero P, Sornay-Rendu E, Delmas PD, Meunier PJ. Age-related changes in os calcis ultrasonic indices: a 2-year prospective study. Osteoporos Int 1995; 5:478–83.

    PubMed  Article  CAS  Google Scholar 

  11. van Daele PLA, Burger H, Algra D, et al. Age-associated changes in ultrasound measurements of the calcaneus in men and women: the Rotterdam study. J Bone Miner Res 1994;9:1751–7.

    PubMed  Article  Google Scholar 

  12. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO technical report series 843. Geneva: WHO, 1994.

    Google Scholar 

  13. Blake GM, Comparative performance of commercial ultrasound scanners. Proceedings of Ultrasonic Assessment of Bone III, May 1993, Stratford upon Avon, UK.

  14. Cawte S, Maslanka W, Rogers AT, Green DJ. Comparative precision and radiation dose of Hologic QDR2000 and Lunar DPX-L. Proceedings of the 11th International Bone Density Workshop, September 1995, Oregon, USA, p6, 62.

  15. Waud CE, Lew R, Baran DT. The relationship between ultrasound and densitometric measurements of bone mass at the calcaneus in women. Calcif Tissue Int 1992;51:415–8.

    PubMed  Article  CAS  Google Scholar 

  16. Agren M, Karellas A, Leahey D, Marks S, Baran D. Ultrasound attenuation of the calcaneus: a sensitive and specific discriminator of osteopenia in postmenopausal women. Calcif Tissue Int 1991;48:240–4.

    PubMed  Article  CAS  Google Scholar 

  17. Funke M, Kopka L, Vosshenrich R, et al. Broadband ultrasound attenuation in the diagnosis of osteoporosis: correlation and osteodensitometry and fracture. Radiology 1995;194:77–81.

    PubMed  CAS  Google Scholar 

  18. Faulkner KG, McClung MR, Coleman LJ, Kingston-Sandahl E, Quantitative ultrasound of the heel: correlation with densitometric measurements at different skeletal sites. Osteoporos Int 1994;4:42–7.

    PubMed  Article  CAS  Google Scholar 

  19. Hans D, Arlot ME, Schott AM, Roux JP, Kotzki PO, Meunier PJ. Do ultrasound measurements on the os calcis reflect more the bone microarchitecture than bone mass? A two-dimensional histomorphometric study. Bone 1995;16:295–300.

    PubMed  Article  CAS  Google Scholar 

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Yeap, S.S., Pearson, D., Cawte, S.A. et al. The relationship between bone mineral density and ultrasound in postmenopausal and osteoporotic women. Osteoporosis Int 8, 141–146 (1998). https://doi.org/10.1007/BF02672510

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  • DOI: https://doi.org/10.1007/BF02672510

Keywords

  • Bone mineral density
  • DXA
  • Osteoporosis
  • Postmenopausal women
  • Reproducibility
  • Ultrasound