Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women. A prospective study. Study of Osteoporotic Fractures Research Group.
Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women. A prospective study. Study of Osteoporotic Fractures Research Group.
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DOI：
10.1001/archinte.1997.00440270067006
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发表时间：
1997-03
影响因子：
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通讯作者：
D. Bauer;C. Glüer;J. Cauley;T. Vogt;K. Ensrud;H. Genant;D. Black
中科院分区：
文献类型：
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作者：
D. Bauer;C. Glüer;J. Cauley;T. Vogt;K. Ensrud;H. Genant;D. Black
骨定量超声是一种新的无辐射技术，可测量骨量并评估骨质量。回顾性研究表明，跟骨低位超声检查与老年女性髋部骨折和其他骨折的风险增加有关。目的通过在骨质疏松性骨折研究中进行前瞻性队列研究，确定跟骨定量骨超声用于预测骨折的实用性，并比较骨定量超声与骨矿物质密度测定。对象和方法我们研究了美国4个临床中心的6189名年龄超过65岁的绝经后妇女。宽带超声衰减（BUA），测量通过跟骨传播的声波的差分衰减，以及跟骨和髋关节的骨矿物质密度。在平均2.0年的随访中记录了随后的髋关节和其他非脊柱骨折。结果在年龄和临床调整分析中，跟骨BUA每减少一个SD，髋部骨折的风险就会增加一倍（相对危险度[RR]，2.0; 95%置信区间[CI]，1.5-2.7）;观察到与跟骨骨矿物质密度相似的关系（RR，2.2; 95% CI，1.9-3.0）和股骨颈（RR，2.6; 95% CI，1.9-3.8）。调整股骨颈骨密度后，BUA仍与髋部骨折风险增加相关（RR，1.5; 95%CI，1.0-2.1）。尤其是转子间骨折与低BUA测量值密切相关（RR，3.3; 95%CI，2.0-5.5）。结论：宽带超声衰减可预测老年妇女骨折的发生，是诊断骨质疏松症的一种有用的检测方法。BUA和骨折之间的关联强度与骨矿物质密度相似。
BACKGROUND Quantitative ultrasound of bone is a new radiation-free technique that measures bone mass and may assess bone quality. Retrospective studies have suggested that low-bone ultrasound of the calcaneus is associated with an increased risk for hip and other fractures in older women. OBJECTIVES To establish the utility of calcaneal quantitative ultrasound of bone for the prediction of fractures and to compare quantitative ultrasound of bone with bone mineral densitometry by performing a prospective cohort study within the Study of Osteoporotic Fractures. SUBJECTS AND METHODS We studied 6189 postmenopausal women older than 65 years of 4 US clinical centers. Broadband ultrasound attenuation (BUA), a measurement of the differential attenuation of sound waves transmitted through the calcaneus, and bone mineral density of the calcaneus and hip were measured. Subsequent hip and other nonspine fractures were documented during a mean follow-up of 2.0 years. RESULTS In age- and clinic-adjusted analyses, each SD reduction in calcaneal BUA was associated with a doubling of the risk for hip fractures (relative risk [RR], 2.0; 95% confidence interval [CI], 1.5-2.7); a similar relationship was observed with bone mineral density of the calcaneus (RR, 2.2; 95% CI, 1.9-3.0) and femoral neck (RR, 2.6; 95% CI, 1.9-3.8). After adjustment for bone mineral density of the femoral neck, BUA was still associated with an increased risk for hip fracture (RR, 1.5; 95% CI, 1.0-2.1). Intertrochanteric fractures in particular were strongly associated with a low BUA measurement (RR, 3.3; 95% CI, 2.0-5.5). CONCLUSIONS Broadband ultrasound attenuation predicts the occurrence of fractures in older women and is a useful diagnostic test for osteoporosis. The strength of the association between BUA and fracture is similar to that observed with bone mineral density.