Skip to main content

Advertisement

SpringerLink
Log in

Association of quantitative heel ultrasound with history of osteoporotic fractures in elderly men: The ESOPO study

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

In order to evaluate the usefulness of calcaneal quantitative ultrasound (QUS) in the assessment of male osteoporosis, a cross-sectional, population-based study was performed. A cohort of 4,832 men, randomly selected, community-dwelling, aged 60–80 years and representative of the general older male Italian population was recruited. QUS measurements were assessed in 83 centers distributed all over Italy and equipped with an Achilles device (GE-Lunar, Madison, Wisconsin, USA). All participants were administered a questionnaire covering lifestyle variables and medical history. Low-energy fractures that had occurred since age 50 were recorded. Overall, 43 subjects reported a previous hip fracture and 455 subjects reported other non-spinal fractures. Univariate analysis showed that fractured subjects were older, with a lower level of outdoor physical activity and a more frequent history of prolonged bedridden periods in comparison with unfractured subjects. Men reporting non-spinal fractures showed a higher prevalence of smoking, while no difference was found among groups in anthropometric measures and calcium intake. QUS measurements showed that all QUS parameters were significantly lower in both fracture groups ( p <0.001). Multiple logistic regression analysis demonstrated that each SD reduction in QUS measures was associated with an approximate doubling of the risk for hip fracture, independent of age and other clinical variables (broadband ultrasound attenuation [BUA]: odds ratio [OR]=2.24; 95% confidence interval [CI] 1.61–3.08; stiffness index: OR=2.19; CI 1.56–3.11; speed of sound [SOS]: OR=1.71; CI 1.18–3.24) and with an increase of the risk of other non-spinal fractures (BUA: 1.38; CI 1.22–1.59; stiffness index: OR=1.27; CI 1.17–1.38; SOS: OR=1.14; CI 0.96–1.40). It can be concluded that calcaneal QUS measurement is associated with the risk for hip fracture and any non-spinal fractures among a community-dwelling cohort of elderly men. The strength of the association between QUS measurement and fracture is similar to that observed in elderly women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Melton LJ 3rd (1993) Hip fractures: A worldwide problem today and tomorrow. Bone 14:S1–S8

    Article  Google Scholar 

  2. Jones G, Nguyen T, Sambrook PN, Kelly PJ, Gilbert C, Eisman JA (1994) Symptomatic fracture incidence in elderly men and women: the Dubbo Osteoporosis Epidemiology Study (DOES). Osteoporos Int 4:277–282

    Article  CAS  PubMed  Google Scholar 

  3. Seeman E (2001) Unresolved issues in osteoporosis in men. Rev Endocr Metab Disord 2:45–64

    Article  CAS  PubMed  Google Scholar 

  4. Melton LJ 3rd, Thamer M, Ray NF et al (1997) Fracture attributable to osteoporosis: Report from the National Osteoporosis Foundation. J Bone Miner Res 12:16–23

    PubMed  Google Scholar 

  5. Cooper C, Campion G, Melton LJ 3rd (1992) Hip fracture in the elderly: a world-wide projection. Osteoporos Int 2:285–289

    CAS  PubMed  Google Scholar 

  6. Nyquist F, Gardsell P, Sernbo I, Jeppsson JO, Johnell O (1998) Assessment of sex hormones and bone mineral density in relation to occurrence of fracture in men: a prospective population-based study. Bone 22:147–151

    Article  CAS  PubMed  Google Scholar 

  7. De Laet CE, Van Hout BA, Burger H, Weel AE, Hofman A, Pols HA (1998) Hip fracture prediction in elderly men and women: validation in the Rotterdam study. J Bone Miner Res 10:1587–1593

    Google Scholar 

  8. Hans D, Dargent-Molina P, Schott AM et al (1996) Ultrasonographic heel measurements to predict hip fracture in elderly women: the EPIDOS study. Lancet 348:511–514

    Article  CAS  PubMed  Google Scholar 

  9. Bauer DC, Glüer CC, Cauley JA et al (1997) Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women. Arch Intern Med 157:629–634

    CAS  PubMed  Google Scholar 

  10. Pluskiewicz W, Drozdzowska B (1999) Ultrasound measurements at the calcaneus in men: differences between healthy and fractured persons and the influence of age and anthropometric features on ultrasound parameters. Osteoporos Int 10:47–51

    Article  CAS  PubMed  Google Scholar 

  11. Mulleman D, Legroux-Gerot I, Duquesnoy B, Marchandise X, Delcambre B, Cortet B (2002) Quantitative ultrasound of bone in male osteoporosis. Osteoporos Int 13:388–393

    Article  CAS  PubMed  Google Scholar 

  12. Pluijm SMF, Graafmans WC, Bouter LM, Lips P (1999) Ultrasound measurements for the prediction of osteoporotic fractures in elderly people. Osteoporos Int 9:550–556

    Article  CAS  PubMed  Google Scholar 

  13. Khaw KT, Reeve J, Luben R et al (2004) Prediction of total and hip fracture risk in men and women by quantitative ultrasound of the calcaneus: EPIC-Norfolk prospective population study. Lancet 363:197–202

    Article  PubMed  Google Scholar 

  14. Adami S, Giannini S, Giorgino R et al (2003) The effect of age, and lifestyle factors on calcaneal quantitative ultrasound: the ESOPO study. Osteoporos Int 14:198–207

    PubMed  Google Scholar 

  15. Prudham D, Evans JG (1981) Factors associated with falls in the elderly: a community study. Age Ageing 10:141–146

    CAS  PubMed  Google Scholar 

  16. Karlsson MK, Duan Y, Ahlborg H, Obrant KJ, Johnell O, Seeman E (2001) Age, gender, and fragility fractures are associated with differences in quantitative ultrasound independent of bone mineral density. Bone 28:118–122

    Google Scholar 

  17. Turner CH, Peacock M, Timmerman L, Neal JM, Johnston CC (1995) Calcaneal ultrasonic measurements discriminate hip fracture independently of bone mass. Osteoporos Int 5:130–135

    Article  CAS  PubMed  Google Scholar 

  18. Schott AM, Weill-Engerer S, Hans D, Duboeuf F, Delmas PD, Meunier PJ (1995) Ultrasound discriminates patients with hip fracture equally well as dual energy X-ray absorptiometry and independently of bone mineral density. J Bone Miner Res 10:243–249

    CAS  PubMed  Google Scholar 

  19. Orwoll E (2000) Perspective: Assessing bone density in men. J Bone Miner Res 15:1867–1870

    CAS  PubMed  Google Scholar 

  20. Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B (2001) Ten-year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int 12:989–995

    Article  CAS  PubMed  Google Scholar 

  21. Aaron J, Makins N, Sagreiya K (1987) The microanatomy of trabecular bone loss in normal aging men and women. Clin Orthop 215:260–271

    PubMed  Google Scholar 

  22. Parfitt AM, Mathews CH, Villanueva AR, Kleerekoper M, Frame B, Rao DS (1983) Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis: Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest 72:1396–1409

    Google Scholar 

  23. Nicholson PH, Muller R, Lowet G et al (1998) Do quantitative ultrasound measurements reflect structure independently of density in human vertebral cancellous bone? Bone 23:425–431

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was totally funded by an unlimited grant from Procter and Gamble, Rome, Italy

Author information

Authors and Affiliations

  1. Dipartimento di Reumatologia, Istituto Ortopedico “Gaetano Pini,” University of Milan, Via G. Pini 9, 20122, Milan, Italy

    M. Varenna & L. Sinigaglia

  2. Riabilitazione Reumatologica, University of Verona, Verona, Italy

    S. Adami

  3. Department of Internal Medicine, University of Padua, Padua, Italy

    S. Giannini, S. Maggi & G. Crepaldi

  4. Institute of Internal Medicine, University of Turin, Turin, Italy

    G. Isaia

  5. Department of Internal Medicine, Umbertide, Perugia, Italy

    P. Filipponi

  6. Department of Internal Medicine, University of Pisa, Pisa, Italy

    O. Di Munno

  7. Department of Geriatrics, University of Catania, Catania, Italy

    D. Maugeri

  8. Procter and Gamble, Rome, Rome, Italy

    D. de Feo

Authors
  1. M. Varenna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Sinigaglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Adami
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Giannini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Isaia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Maggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. Filipponi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. O. Di Munno
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. D. Maugeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. D. de Feo
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. G. Crepaldi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Varenna.

Appendix: Local coordinators of the ESOPO study

Appendix: Local coordinators of the ESOPO study

Antonino Accardi, Marsala (TP); Alberto Angeli, Orbassano (TO); Salvatore Baglio, Roma; Alfonso Baldoncini, Arezzo; Pierluigi Ballardini, Lagosanto (FE); Cataldo Bancheri, Roma; Franco Beghe, Imperia; Luigi Bernini, S. Miniato (PI); Maurizio Bevilacqua, Milano; Gerolamo Bianchi, Arenzano (GE); Giuseppe Bonomi, Palmanova (UD); Massimo Bottai, Sarzana (SP); Giovanni Brogi, Pescia (PT); Giuseppe Candioto, Agrigento; Sergio Candiotto, Dolo (VE); Riccardo Cecchetti, Pontedera (PI), Raffaele Cerqua, S. Felice a Cancello (CE); Sandro Cervelli, Roma; Stefano Coaccioli, Terni; Franco Coin, Dolo (VE); Cataldo Colella, Aversa (CE); Daniele Costi, Parma; Massimo Cravero, Torino; Salvatore D’Auria, Benevento; Giovanni D’Avola, Catania; Nicola De Gennaro, Capua (CE); Lucio Del Forno, Vasto (CH); Arturo D’Elia, Napoli; Ombretta Di Munno, Pisa; Roberto Di Virgilio, Treviso; Filippo Favazzi, Mistretta (ME); Mario Ferraris, Vercelli; Paolo Filipponi, Umbertide (PG); Cristiano Maria Francucci, Ancona; Bruno Frediani, Siena; Giorgio Gandolini, Milano; Romildo Gasparini, Legnago (VR); Romeo Gatti, Viterbo; Salvatore Gatto, Napoli; Ernesto Gemini, Napoli; Tommaso Gismondi, Bari; Stefano Gonnelli, Siena; Siro Grassi, Napoli; Giovanni Iolascon, Napoli; Giancarlo Isaia, Torino; Tommaso Izzo, Nocera Inferiore (SA); Giovanni La Montagna, Napoli; Renato La Forgia, Matera; Giovanni Lapadula, Bari; Gaetano Loiacono, Martina Franca (TA); Pierluigi Lombardi, Castelnuovo (LU); Roberto Lovato, Vicenza; Riccardo Maglitto, Lentini (SR); Fabio Magnani, Vignola (MO); Nazzarena Malavolta, Bologna; Giorgio Mancini, Macerata; Giuseppe Masellis, Carpi (MO); Domenico Maugeri, Catania; Carmelo Micale, Cuggiono (MI); Redento Mora, Pavia; Maurizio Muratore, S. Cesario di Lecce (LE); Rita Occhipinti, Belluno; Geremia Oliva, Frattamaggiore, (NA); Ernesto Palummeri, Genova; Domenica Panzavecchia, Partinico (PA); Salvatore Parello, Canelli (AT); Raffaele Pellerito, Torino; Giovanni Pisanu, Oristano (CA); Domenico Policicchio, Avellino; Marco Pozone, L’Aquila; Giulio Pucci, Spoleto (PG); Stefano Respizzi, Rozzano (MI); Giuseppe Roberti, Chivasso (TO); Maurizio Rossini, Verona; Sergio Rossitto, Piazza Armerina (EN); Luciano Sabadini, Arezzo; Carlo Salvarani, Reggio Emilia; Salvatore Salvini, Anzio (RM); Giuseppe Santeufemia, Iglesias (CA); Ivana Santi, Milano; Leonardo Sartori, Padova; Mario Sfrappini, S. Benedetto del Tronto (AP); Ferdinando Silveri, Jesi (AN); Luigi Sinigaglia, Milano; Michele Soriano, Vibo Valentia; Ruggero Spinazze, Conegliano (TV); Giuseppe Stancati, Cosenza; Giancarlo Tartarelli, Massa; David Topini, Viterbo; Francesco Trotta, Ferrara; Giuseppe Varcasia, Castrovillari (CS); Alfredo Zanatta, Legnago (VR)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Varenna, M., Sinigaglia, L., Adami, S. et al. Association of quantitative heel ultrasound with history of osteoporotic fractures in elderly men: The ESOPO study. Osteoporos Int 16, 1749–1754 (2005). https://doi.org/10.1007/s00198-005-1914-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-005-1914-4

Keywords

Search

Navigation