Preliminary screening of osteoporosis and osteopenia in middle aged urban women from Hyderabad (INDIA) using calcaneal QUS.

Background: Osteoporosis is a major public health problem, associated with substantial morbidity and socio-economic burden. An early detection can help in reducing the fracture rates and overall socio-economic burden in such patients. The present study was carried out to screen the bone status (osteopenia and osteoporosis) above the age of 25 years in urban women population in this region. Methods: A hospital based study was carried out in 316 women by calculating T-scores utilizing calcaneal QUS as diagnostic tool. Results: The result suggested that a substantial female population had oesteopenia and osteoporosis after the age of 45 years. The incidence of osteoporosis was (20.25%) and osteopenia (36.79%) with maximum number of both osteoporosis and osteopenic women recorded in the age group of (55-64 years). After the age of 65 years, there was an almost 100% incidence of either osteopenia or osteoporosis, indicating that it increases with age and in postmenopausal period, thereby suggesting lack of estrogenic activity might be responsible for this increasing trend. Religion, caste and diet had an influence on the outcome of osteopenic and osteoporosis score in present study, but still it has to be substantiated by conducting larger randomized clinical trials in future. Conclusions: A substantial female population was screened for osteoporosis and osteopenia using calcaneal QUS method utilizing same WHO T score criteria that otherwise shall remain undiagnosed and face the complications and menace of osteoporosis.

Quantitative Ultrasound (QUS) for the Assessment of Bone Health

Osteoporosis is known as a silent disease because bone density slowly decreases with advancing age and without symptoms. The incidence of osteoporosis is increasing yearly worldwide. Measuring bone mineral density (BMD) using conventional bone densitometry (DXA) is practical in diagnosis of osteoporosis but the cost is high and cannot be implemented in community. However, quantitative ultrasound (QUS) is a modern technique to measure the bone density and also for the diagnosis of osteoporosis. It is comparatively easy, reliable, less costly, and a safe method compared to other techniques. QUS consists of two main parameters which are known as broadband ultrasound attenuation (BUA) and speed of sound(SOS). QUS can also predict fracture risk of BMD. QUS showed significantly associated with BMD, bone micro architecture and mechanical parameters for In vitro studies and in human studies, QUS were found to be associated with BMD. Hence, QUS is capable to be new technique for bone assessment.

Bone Health Status among Thalassemia Children

Low bone mineral density is a significant problem in children with Thalassemia which may lead to increased risk for fragility fractures and suboptimal peak bone mass. This cross-sectional study was conducted to determine the bone health status of Thalassemia children Universiti Kebangsaan Malaysia Medical Centre and Paediatrics Insititute Kuala Lumpur Hospital. A total of 81 respondents diagnosed with transfusion dependant beta Thalassemia (41 boys and 40 girls) aged between 7 to 19 years old completed the study. The data collected were demographic information, anthropometric measurements, dairy frequency questionnaires, dietary habits of the respondents and their parents, dietary intakes and bone densitometry using Ultrasound Bone Densitometer. For Quantitative Ultrasound (QUS) parameters, T-score of 9.8% participants were lower than -1.0 and 30.9% of the participants had lower Speed of Sound (SOS) than healthy SOS. This study showed there was no difference in bone density by sex (p>0.05). The median bone density of boys was 1616.00 m/ sec (IQR= 39.00) and girls’ was 1579.00 m/ sec (IQR= 116.00). SOS was not increased with age, height and weight; but girls’ Body Mass Index (BMI). Malay children had significantly higher SOS than non-Malay children. This study highlights a need of proper intervention for the high risk group to achieve optimal bone health.

Bone Mineral Density Assessment in Pre- and Postmenopausal Women: Comparison Between T-Scores by Heel QUS and DXA in HRPZII

This short-term study which was carried out in a small group of pre- and postmenopausal women at Hospital Raja Perempuan Zainab II (HRPZII) aims to compare between Tscores detected by heel Quantitative Ultrasound (QUS) and by Dual X-ray Absorptiometry (DXA) of the hip and spine. The prevalence of osteoporosis by heel QUS was 63.3% and up to 16.7% by DXA. Insufficient or weak agreement exists between T-score measurements by heel QUS and axial DXA. Significant correlations were found between measurements of T-scores by both methods, with r values from 0.364 to 0.91. Although some correlation was found, significant discrepancy in the frequency of osteoporosis using different methods and sites is substantial.

Effects of Milk Consumption on Calcaneal Quantitative Ultrasound and Bone Turnover Markers of Women Living in Asan / 대한지역사회영양학회지

The objective of this study is to determine the effectiveness of 16-month milk consumption as a part of the health promotion community program for women in Asan. Subjects included 313 women belonging to the milk group (mean age = 69.1, range 47~89 y) and 66 women to the control (mean age = 43.6, range 20~69 y) group. For those in the milk group, one cup (200ml) of partially lactose-digested low-fat milk was provided everyday for 16 months. Each subject was interviewed to assess calcium intake by a 24-h recall after fasting blood was obtained for analyzing bone turnover markers, and calcaneus broadband ultrasound attenuation (BUA) was measured by quantitative ultrasound (QUS) on the left heel before and after the milk supplementation. After 16 months, the calcium intake levels changed from 55% of recommended dietary allowance (RDA) to 85% RDA in the milk group and from 73% RDA to 84% RDA in the control group. BUA were reduced from 67.9+/-8.1 to 64.7+/-17.5 dB/MHz for milk and from 90.4+/-13.0 to 87.2+/-15.2 dB/MHz for control groups. Paired ttest showed the changes of BUA for both groups (-3.24 and -3.15 dB/MHz for milk and control groups, respectively) were significant, but the two groups did not show any differences in absolute changes. When post-BUA was analyzed after age, initial BUA and menopausal status were controlled as covariates in ANCOVA model, the milk group showed significantly (p < 0.05) smaller changes than the control group (-3.50 vs -6.71 dB/MHz, respectively). According to a multiple regression analysis, milk consumption and initial BUA showed significant interaction meaning that those with lower initial BUA showed higher milk effects. We conclude that one-cup a day milk consumption for 16 month can prevent further bone loss and significantly improve calcium intake.

INFLUENCE OF ANTHROPOMETRIC MEASURES AND LIFESTYLE-RELATED FACTORS ON THE TWO-YEAR CHANGES OF BONE MASS IN COLLEGE-AGED WOMEN / 体力科学

The college years are an opportune timepoint of intervention in the primary prevention of osteoporosis. However, the effects of anthropometrical measures and lifestyle-related factors on the changes in bone mass during college years are unclear. The purpose of this study was thus to identify the determinants of the changes in calcaneal quantitative ultrasound (QUS) bone parameters (stiffness index: SI, speed of sound: SOS, broadband ultrasound attenuation: BUA) over 2 years in healthy Japanese college women (n=128). Correlation analysis revealed several significant relationships between the change rates in QUS parameters and anthropometry. Particularly, the changes in SI and BUA are highly correlated with the 2-year change in lean body mass (LBM). The subsequent multiple liner regression analysis also supported that the change in LBM was the significant predictor for the incremental rate of SI and BUA. All subjects then categorized into some grades, concerning about following lifestyle-related and physical variables during the last 2 years, living condition, sleeping time, alcohol consumption, smoking, meal skipping, dairy foods intake, instant foods intake, regular physical activity, regularity of menstruation, history of fracture, and history of dieting to reduce body weight. The incremental rates of all QUS parameters (i. e., SI, SOS, BUA) were positively associated with participation in regular physical activity. In addition, women who have continuously participated in regular physical activity from high school to college showed significant increases in SI and SOS compared with those who are not physically active or whose level of physical activity decline during college years. In conclusion, our study indicates that changes in QUS parameters in college-aged women were influenced by changes in anthropometric measures, especially LBM. It might suggest the importance of participation in regular physical activity to increase skeletal muscle mass. Our results also support the view that college women should maintain or increase regular physical activity before and after entering the college to maximize peak bone mass or lessen the age-related loss in bone mass in adulthood.

Osteoporosis Prevalence of Radius and Tibia and Related Factors Using Multiple Bone Sites Quantitative Ultrasound Measurement of the Korean Health and Genome Study Cohort Women / 대한지역사회영양학회지

This study was conducted to investigate osteopenia and osteoporosis prevalence of radius and tibia using Quantitative Ultrasound (QUS) and to identify affecting factors of osteoporosis. A total of 4,340 women aged 40 - 69 years, living in Ansung (rural) and Ansan (mid-sized) area, and free of illnesses affecting bone metabolism participated in the community-based cohort study. Among them 4,059 subjects measured radius bone density and 4,089 measured tibia. The T-score threshold, defined as or = 30) were significantly increased. The OR of osteoporosis decreased across increasing quartiles of intakes of Ca, P and Ca/P. Therefore, maintaining normal BMI and increasing Ca intake and Ca/P ratio may have a beneficial effect on bone health of Korean women.

Quantitative ultrasound test of calcaneus in 647 women in Guangzhou area / 中国康复理论与实践

@#ObjectiveTo study changes of bone measured with quantitative ultrasound (QUS) in women of Guangzhou area and provide scientific basis for prevention and treatment of osteoporosis (OP).MethodsCalcaneus measurement was done with QUS in 647 women of Guangzhou area, and measurement data was analyzed.ResultsIn menopause and aged women, broadband ultrasound attenuation (BUA) showed a significantly decrease (P<0.01), whereas it decreased only slightly in early postmenopausal women (P>0.05). After the peak of BMD, speed of sound (SOS) showed a stepwise decline, and significantly decrease in menopause (P<0.01), but not significant over eighties (P>0.05). In contrast, stiffness index (STI) significantly decreased from the menopause, and it was a better indicator than BUA or SOS.ConclusionQUS can not only test bone mass but also assess microarchitecture, and it is nonradioactive, cheaper, easier to use, and may play a important role in diagnosis of osteoporosis and women and senile health.