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Influence of anthropometric parameters and biochemical markers of bone metabolism on quantitative ultrasound of bone in the institutionalized elderly

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Abstract

The assessment of bone quality by quantitative ultrasound (QUS), a transportable and relatively cheap method, shows some correlations with bone mineral density (BMD) as measured by dual-energy X-ray absorptiometry (DXA) and with fracture risk. To examine its correlation with bone metabolism in a population of institutionalized elderly people known to be at high risk for vitamin D deficiency and secondary hyperparathyroidism, QUS of the calcaneus and biochemical parameters were measured in 264 women aged 85±7 (SD) years and in 103 men aged 81±8 years living in 19 nursing homes. Vitamin D deficiency was frequent in this population: 41.9% of the women and 31.4% of the men had a serum 25-hydroxyvitamin (25OHD) level below the 2.5th percentile level of 3276 normal Swiss adults (6.2 µg/l or 15.5 mmol/l). Hyperparathyroidism was less frequent: serum parathyroid hormone (PTH) levels were above the 97.5th percentile level of normal adults (70 pg/l) in 18.9% of women and 9.8% of men. In women, QUS data correlated significantly with age (r=−0.297), body mass index (BMI) (r=0.403), calcium (r=0.220), PTH (r=−0.296), 25OHD (r=0.298) and alkaline phosphatase (AP) (r=−0.170) for broadband ultrasound attenuation (BUA), and with age (r=−0.195), BMI (r=0.208), PTH (r=−0.174), 25OHD (r=0.140) and AP (r=−0.130) for speed of sound (SOS). In men, ultrasound data correlated with BMI (r=0.326), calcium (r=0.199), 25OHD (r=0.258) and AP (r=−0.311) for BUA, and with AP (r=−0.196) for SOS. In women, but not in men because of their smaller number, a multivariate analysis was performed to examine relationships between age, BMI, biochemical markers and QUS. Age, BMI, PTH and phosphate explained 30% of the variance of BUA and 10% for SOS. In conclusion, QUS of bone evaluates characteristics of bone that are influenced, at least partially, by age, BMI and the secondary hyperparathyroidism due to vitamin D deficiency.

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Authors and Affiliations

  1. Department of Internal Medicine, University Hospital - CHUV, CH-1011, Lausanne, Switzerland

    M.-A. Krieg, A. F. Jacquet, D. Thiébaud & P. Burckhardt MD

  2. Institute of Social and Preventive Medicine, Lausanne, Switzerland

    J. Cornuz

Authors
  1. M.-A. Krieg
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  2. J. Cornuz
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  3. A. F. Jacquet
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  4. D. Thiébaud
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  5. P. Burckhardt MD
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Part of this work was presented at the 17th Annual Meeting of the American Society of Bone and Mineral Research in Baltimore, MA, USA, September 1995.

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Krieg, MA., Cornuz, J., Jacquet, A.F. et al. Influence of anthropometric parameters and biochemical markers of bone metabolism on quantitative ultrasound of bone in the institutionalized elderly. Osteoporosis Int 8, 115–120 (1998). https://doi.org/10.1007/BF02672506

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  • DOI: https://doi.org/10.1007/BF02672506

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