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Objective To compare the consistency of quantitative ultrasound(QUS)and dual-energy X-ray absorptiometry(DXA)in measuring bone mineral density(BMD)of adults aged 18-40 years in Guangzhou and evaluate the diagnostic value of QUS for identifying low bone mass.Methods DXA was employed to measure the BMD and QUS to measure the speed of sound(SOS)in 731 participants.The Bland-Altman analysis was performed to evaluate the consistency of Z scores between SOS and BMD.With the BMD Z ≤-2.00 as the diagnostic criterion for low bone mass,the receiver operating characteristics curve of QUS was established,and the area under the curve(AUC)and the sensitivity,specificity,and correct diagnostic index for the optimal cut-off of SOS Z score were calculated.Results The results of Bland-Altman analysis showed that the mean differences in the Z scores of SOS and BMD in males and females were 1.27(-0.94 to 3.47)and 0.93(-1.33 to 3.18),respectively.The AUC of SOS Z score in the diagnosis of low bone mass in males and females was 0.734(95%CI=0.380-0.788)and 0.679(95%CI=0.625-0.732),respectively.In males,the optimal cut-off of SOS Z score for low bone mass was -0.35,with the sensitivity,specificity,and correct diagnostic index of 64.1%,68.6%,and 0.327,respectively.In females,the optimal cut-off value of SOS Z scores for low bone mass was -1.14,with the sensitivity,specificity,and correct index of 73.9%,54.8%,and 0.285,respectively.Conclusion QUS and DXA show poor consistency in the diagnosis of BMD in the adults aged 18-40 years in Guangzhou,while QUS demonstrates an acceptable value in identifying low bone mass.
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Male , Female , Adult , Humans , Absorptiometry, Photon/methods , Bone Density , Ultrasonography , Bone and Bones , ROC Curve , Sensitivity and SpecificityABSTRACT
Osteoporosis has become a common chronic disease which seriously endangers the health of the elderly. China is facing high incidence of osteoporosis along with " three low" rates of screening, diagnosis, and treatment, the crux of which lies in the lack of convenient and effective screening methods for osteoporosis. DXA, the gold standard for the diagnosis of osteoporosis, has many setbacks such as expensive, radiation, and low accessibility in community, etc. which limits its application in large scale screening. The community screening methods for osteoporosis recommended by national guidelines are IOF one-minute test, osteoporosis self-assessment tool for Asians(OSTA), fracture risk assessment tool(FRAX ?), and quantitative ultrasound(QUS). In recent years, digital X-ray radiogrammetry(DXR) and opportunistic quantitative computed tomography(QCT)have also shown great potential in osteoporosis screening. This article reviews the application and research progress of the above screening methods, with the aim of improving the screening rate and contributing to the tertiary prevention and control mechanism of " wide awareness, early diagnosis and early treatment" of osteoporosis.
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Bone mineral loss is a serious health issue all over the globe resulting in osteoporosis, without showing any pre-indication of its occurrence. Dual Energy X-ray Absorptiometry test is a widely accepted method for its diagnosis which gives areal information about the bone mineral. Other methods like Quantitative Computed Tomography (QCT) and Peripheral QCT give volumetric information. Application of these methods for mass screening is not recommended due to the use of ionizing radiations. Few non-ionizing methods, namely Bioelectric Impedance Analysis and Quantitative Ultrasound, have evolved in the past few decades. Bioelectric Impedance Analysis, a non-invasive and low-cost tool, has been immensely recognized for its promising use in estimating body composition and body fluids. Similarly, Quantitative Ultrasound is another non-invasive technique for determining bone density at fixed locations, making noninvasive assessment much faster, easier to use, and portable. A multi-parametric approach combining these two modalities has yielded higher efficiency for the detection of bone mineral loss. These developments are briefly reviewed in this paper.
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The incidence of non-alcoholic fatty liver disease(NAFLD)keeps on rise.Without intervention,it may develop to steatohepatitis,cirrhosis,and even hepatocellular carcinoma.Liver biopsy,the gold standard for evaluating the steatosis severity of NAFLD,is invasive and unsuitable for large-scale screening.In recent years,magnetic resonance imaging(MRI)-related examinations have been used as a gold standard only second to liver biopsy,which still have disadvantages in large-scale application.Ultrasound has the advantages of simple operation,low cost,and safety,and may become an important method for accessing NALFD.This review summarizes the current studies about the diagnosis of liver steatosis by quantitative ultrasound assessment,including controlled attenuation parameters,attenuation imaging,ultrasonic liver/kidney intensity ratio and liver attenuation rate,and integrated backscatter.
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Humans , Biopsy , Liver/diagnostic imaging , Liver Neoplasms , Magnetic Resonance Imaging , Non-alcoholic Fatty Liver Disease/diagnostic imaging , UltrasonographyABSTRACT
Background: Mainstay of therapy in the idiopathic nephrotic syndrome is glucocorticoids. Glucocorticoid induced osteoporosis is considered as most prevalent type of secondary osteoporosis. Only limited studies are conducted in tropical nations. Therefore our study is undertaken with objectives to evaluate Glucocorticoid therapy impact on bone health in Nephrotic Syndrome (NS) children by 2 different tools, namely urinary calcium and bone mineral density (BMD) by Quantitative ultrasound (QUS) and compare both the tools.Methods: Total 42 children with NS who completed minimum 12 weeks of Glucocorticoid therapy (6 weeks of daily regimen and minimum 6 weeks of alternate day regimen) were subjected to 24 hour Urinary calcium and Bone Mineral density by QUS at Tertiary health centre, Kalaburagi.Results: Out of 42 cases, 45.2 % had Osteopenia and 2.4% had osteoporosis, so 47.6% of them had BMD measured by QUS. Hypercalciurea was seen in 10 out of 42 cases (23.8%). In normal BMD group only 0.5% had hypercalciurea, Osteopenia group had 47.4% of cases and all osteoporosis group had hypercalciurea.Conclusions: Present study data concludes that children with NS treated with Glucocorticoids are at risk of Negative impact on bone health. Though both the tools detect impact of Glucocorticoids on bone health, BMD by QUS has better rate then urinary calcium in detecting negative effect of Glucocorticoid on bone health. As BMD by QUS decreases, Urinary calcium increases reflecting inverse relation between them.
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Objective: To compare the efficacy of daily assisted physicalexercise (starting from one week of postnatal age) on bonestrength at 40 weeks of post menstrual age to no intervention ininfants born between 27 and 34 weeks of gestation.Design: Open-label randomized controlled trial.Setting: Tertiary-care teaching hospital in northern India from 16May, 2013 to 21 November, 2013.Participants: 50 preterm neonates randomized to Exercisegroup (n=26) or Control group (n=24).Intervention: Neonates in Exercise group underwent onesession of physical exercise daily from one week of age, whichincluded range-of-motion exercises with gentle compression,flexion and extension of all the extremities with movements ateach joint done five times, for a total of 10-15 min. Infants inControl group underwent routine care and were not subjected toany massage or exercise Outcome measures:Primary: Bone speed of sound of lefttibia measured by quantitative ultrasound at 40 weeks postmenstrual age. Secondary:Anthropometry (weight length andhead circumference) and biochemical parameters (calcium,phosphorus, alkaline phosphatase) at 40 weeks post menstrualage.Results:The tibial bone speed of sound was comparablebetween the two groups [2858 (142) m/s vs. 2791 (122) m/s;mean difference 67.6 m/s; 95% CI - 11 to 146 m/s; P=0.38]. Therewas no difference in anthropometry or biochemical parameters.Conclusion:Daily assisted physical exercise does not affectthe bone strength, anthropometry or biochemical parameters inpreterm (27 to 34 weeks) infants.
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Objective To investigate the effect of quantitative ultrasound bone mineral density test on the screening of osteoporosis in patients with knee osteoarthritis and to explore the relationship between knee osteoar-thritis and osteoporosis. Methods 160 patients with knee osteoarthritis were divided into 4 groups:Ⅰ,Ⅱ,ⅢandⅣby Kellgren-Lawrence and measured height,weight,age,quantitative ultrasound bone mineral density and dual energy X-ray bone density.We compared the T values measured by quantitative ultrasound bone mineral density test and dual energy X-ray bone density,assessed the accuracy of quantitative ultrasound bone mineral density test for osteoporosis,and investigated the correlation between the value of quantitative ultrasound bone mineral density and knee osteoarthritis in different grades. Results Quantitative ultrasound bone mineral density was positively correlated with dual energy X-ray bone density(r = 0.751,P < 0.05). The AUC of diagnosis of osteoporosis by quantitative ultrasound bone mineral density test with T<-2.5 was 0.774,95% CI was 0.676 and 0.791,specificity was 96.7%,sensitivity was 85.7% and Youden index was 82.4%.With an increase in the grades of Kellgren-Law-rence,the knee osteoarthritis gradually worsened.The T values of quantitative ultrasound bone mineral density and dual energy X-ray bone density increased gradually in negative direction,and the difference was statistically signifi-cant(P<0.001).Conclusions Quantitative ultrasound bone mineral density test has good specificity and sensi-tivity and can be used to screen patients with knee osteoarthritis. The more severe the knee osteoarthritis is,the easier to develop osteoporosis.
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Objective To describe the regional and population-related differences in calcaneus bone mineral density (BMD) across ten regions of China.Methods Based on the results from the second Re-survey of China Kadoorie Biobank project,in which 5％ of the surviving participants were interviewed during 2013-2014 and 24 677 participants aged 38-87 years were included in the study.We excluded those people with missing data for BMD and important variables.Calcaneus BMD was measured using the quantitative ultrasound bone densitometer.We analyzed four indexes,including broadband ultrasound attenuation (BUA),speed of sound (SOS),stiffness index (SI),and T score.Results The average calcaneus BMDs of the present population were:BUA (109.7 ± 12.6) dB/MHz,SOS (1 554.7 ± 45.6) m/s,SI (88.3 ± 18.8),T score (-0.74 ± 1.28).Urban residents showed higher calcaneus BMD,so as in men.The calcaneus BMD decreased by age,with a larger decline seen in women.Current smokers and postmenopausal women presented lower calcaneus BMD,while in those who frequently drank milk or yogurt or being physically more active,had higher calcaneus BMD.Conclusion Calcaneus BMD varied greatly among people from the ten regions of CKB study and among participants having different demographic characteristics,lifestyle behaviors or health conditions.
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Objective To describe the regional and population-related differences in calcaneus bone mineral density (BMD) across ten regions of China.Methods Based on the results from the second Re-survey of China Kadoorie Biobank project,in which 5％ of the surviving participants were interviewed during 2013-2014 and 24 677 participants aged 38-87 years were included in the study.We excluded those people with missing data for BMD and important variables.Calcaneus BMD was measured using the quantitative ultrasound bone densitometer.We analyzed four indexes,including broadband ultrasound attenuation (BUA),speed of sound (SOS),stiffness index (SI),and T score.Results The average calcaneus BMDs of the present population were:BUA (109.7 ± 12.6) dB/MHz,SOS (1 554.7 ± 45.6) m/s,SI (88.3 ± 18.8),T score (-0.74 ± 1.28).Urban residents showed higher calcaneus BMD,so as in men.The calcaneus BMD decreased by age,with a larger decline seen in women.Current smokers and postmenopausal women presented lower calcaneus BMD,while in those who frequently drank milk or yogurt or being physically more active,had higher calcaneus BMD.Conclusion Calcaneus BMD varied greatly among people from the ten regions of CKB study and among participants having different demographic characteristics,lifestyle behaviors or health conditions.
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OBJECTIVES: This study aimed to investigate differences in physical function by bone mass category as assessed by speed of sound, and the association between bone mass and physical function in Japanese elderly women. METHODS: Participants (≥65 years, n = 954) were divided into the osteoporosis, osteopenia, and normal groups based on speed of sound values, and physical function parameters were compared among groups. In addition, the predictive ability of physical function for low bone mass was determined by area under the curve analysis. Data were collected in 4 cities in Nara, Japan, in 2007 or 2008. RESULTS: All physical functions were significantly lower in the osteoporotic group than in the normal group. Lower bone mass was associated with poor muscle strength and physical function after adjusting for age, height and weight. In addition, one-leg standing time and 10-m gait time were predictive of low bone mass (osteopenia and osteoporosis levels, respectively). Elderly women with low physical function, especially those with a short one-leg standing time, should be suspected of having decreased bone mass. CONCLUSIONS: Measurements of physical function can effectively identify elderly women with low bone mass at an early stage without the need for bone mass measurements. In particular, one-leg standing time and 10-m gait time were good predictors of low bone mass, and is easy to measure, low-cost, and can be self-measured. These findings will be helpful in the prevention and treatment of osteoporosis.
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Aged , Female , Humans , Asian People , Bone Diseases, Metabolic , Gait , Japan , Muscle Strength , Osteoporosis , UltrasonographyABSTRACT
Objective To determine the amount of serum Vitamin D in premature infants,and to investigate its correlation with bone quantitative ultrasound measurement.Methods The serum of premature infants born between 2013 March and 2014 March in the Maternal and Children Health Hospital of Huadu District in Guangzhou were collected,and serum 25-hydroxyvitamin D [25-(OH) D] level was measured by using chemiluminescence immunoassay,while Omnisense quantitative ultrasound was used to measure bone speed of sound(SOS) in the middle area of the left tibia.According to gestational age,the participants were divided into A,B and C groups(28-32 weeks,32 +1-34 weeks,34 + 1-36 +6 weeks,respectively).The levels of 25-(OH)D and SOS were compared and the correlation between them was analyzed.Results The amount of 25-(OH) D of the 3 groups was (41.65 ± 21.15) nmoL/L,(47.15 ± 19.78) nmol/L,and (49.35 ± 19.93) nmol/L,respectively,and the differences among the 3 groups were statistically significant (F =4.441,P =0.012).The ratio of vitamin D abundant or not (insufficiency including deficiency and lack) in preterm among the 3 groups were compared,and the differences among the 3 groups were statistically significant(x2 =11.38,P =0.023).SOS of the 3 groups were (2 787.85 ± 123.01) m/s,(2 865.12 ± 129.44) m/s and (2 908.59 ± 124.01) m/s,respectively,and the differences among the 3 groups were statistically significant (F =28.716,P =0.000).There was a positive correlation between 25-(OH) D and SOS (r =0.084,P =0.024).Conclusions Level of Vitamin D in premature infants is generally inadequate.The smaller the gestational age,the higher the occurrence rate.Vitamin D levels and SOS are significantly positively correlated,and both of them increase with gestational age.
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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.
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Objective To evaluate the diagnostic value of quantitative ultrasound test (QUS) in osteoporosis screening by comparing stiffness index (STI) calculated by QUS and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in Chinese community population.Methods A total of 6 105 residents aged 45 years and over from Shanghai Changfeng community were recruited.BMD of lumbar spine (L1-L4) and both femur measured by DXA and calcaneus STI calculated by QUS were observed simultaneously in the same day.The sensitivity,specificity and accuracy of QUS and DXA (gold standard) on the diagnosis of osteoporosis were compared.Results The prevalence of osteopenia or osteoporosis diagnosed by DXA and QUS was 38.82％,10.29％ and 64.50％,4.49％ respectively.STI was correlated with BMD of spine,left and right femur,respectively with the correlation coefficients of 0.536,0.574 and 0.570 (all P ＜ 0.001).The sensitivity and specificity of QUS for osteopenia was 86.16％ and 47.57％ and for osteoporosis was 23.57％ and 97.70％.Conclusion STI calculated by QUS had a good correlation with BMD measured by DXA.The high sensitivity and specificity of QUS made it as a diagnostic tool for osteopenia and osteoporosis screening in community health care center.
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Objective To observe the glucocorticoid-induced osteoporosis (GIOP) in children with kidney diseases by quantitative ultrasound (QUS), and to analyze its influencing factors.Methods The tibia/radius bone mineral density(BMD) was checked obtained in 67 cases with childhood kidney diseases treated with glucocorticoid by QUS,BMD was measured in children over the age of 12 by dual-energy X-ray absorptiometry(DXEA) ,and BMD was measured with QUS consistency and different stages of osteoporsis were compared.The clinical data of gender, age,body mass index(BMI) ,administration duration and daily dosage of glucocorticoid were analyzed.The association between the duration of glucocorticoid use,and daily dosage of glucocorticoid and the different degrees of BMD was analyzed by Logistic regression analysis.Results Sixty-seven patients(male 45 ,female 22) were divided into 4 groups according to the reference standard of Asian children BMD data provided by Sunlight Company:the normal BMD group(41 cases), the mild osteoporosis group (18 cases), moderate osteoporosis group (5 cases), and severe osteoporosis group (3 cases).Both QUS and DEXA were highly correlated with BMD in patients measured (P ＞ 0.05).The duration of glucocorticoid treatment and daily dosage of glucocorticoid in 3 abnormal BMD groups were all significantly longer and larger than those of the normal BMD group (all P ＜ 0.05).Correlation analysis showed that BMI was positively correlated with the bone mass of the tibia(r =0.395 ,P ＜ 0.01).The duration of glucocorticoid treatment and daily dosage of glucocorticoid were negatively correlated with those of radius BMD(r =-0.474,-0.381 ,all P ＜ 0.01).Analysis showed that both the duration of glucocorticoid,and the daily dosage of glucocorticoid were the risk factors for GIOP.Conclusions QUS is a better method for evaluating of BMD and diagnosing of GIOP compared with DEXA in children.The daily dosage of glucocorticoid and the duration of glucocorticoid treatment are both the risk factors for GIOP.
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Background: Osteoporosis is characterized by low bone mineral density (BMD) and an increased risk of fractures with advancing age in postmenopausal women. BMD measurements with dual energy X-ray absorptiometry (DEXA) are costly and not widely available The Osteoporosis Self-Assessment Tool for Asians (OSTA) index is a simple tool based on age and body weight to predict low BMD and identify women at risk of osteoporosis. The objective was to study the association of OSTA index with BMD (T-score) and to validate OSTA index in comparison with calcaneal Quantitative Ultrasound (QUS) for the prediction of low BMD in peri-menopausal Indian women. Methods: This was a prospective, cross-sectional, descriptive study carried out in department of physiology of a tertiary care teaching hospital (Navi Mumbai). Seventy two peri-menopausal women between 40 to 55 years with no previous diagnosis of osteoporosis were included. Participants’ socio-demographic detail, anthropometric measurements, OSTA index and QUS-based BMD was recorded. Pearson’s correlation test was used. Sensitivity, specificity, positive and negative predictive value was calculated. Results: OSTA index did not correlate with BMD in the entire samples. On subgroup analysis, OSTA index significantly correlated in a positive direction with BMD (T-score) in women in the age group of 50-55 years. OSTA index had a sensitivity of 70 %, and specificity of 84.62 % at T-score cutoff value of < -1. Conclusions: OSTA index is a simple risk assessment tool that can be used to identify women with low BMD in the age group of 50-55 years.
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A simple experimental protocol applying a quantitative ultrasound (QUS) pulse-echo technique was used to measure the acoustic parameters of healthy femoral diaphyses of Wistar rats in vivo. Five quantitative parameters [apparent integrated backscatter (AIB), frequency slope of apparent backscatter (FSAB), time slope of apparent backscatter (TSAB), integrated reflection coefficient (IRC), and frequency slope of integrated reflection (FSIR)] were calculated using the echoes from cortical and trabecular bone in the femurs of 14 Wistar rats. Signal acquisition was performed three times in each rat, with the ultrasound signal acquired along the femur's central region from three positions 1 mm apart from each other. The parameters estimated for the three positions were averaged to represent the femur diaphysis. The results showed that AIB, FSAB, TSAB, and IRC values were statistically similar, but the FSIR values from Experiments 1 and 3 were different. Furthermore, Pearson's correlation coefficient showed, in general, strong correlations among the parameters. The proposed protocol and calculated parameters demonstrated the potential to characterize the femur diaphysis of rats in vivo. The results are relevant because rats have a bone structure very similar to humans, and thus are an important step toward preclinical trials and subsequent application of QUS in humans.
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Animals , Bone Density/physiology , Femur , Ultrasonography/methods , Diaphyses , Inventions , Models, Biological , Rats, Wistar , Statistics, NonparametricABSTRACT
Objective To measure the values of quantitative ultrasound(QUS) of different gestational age preterm infants at birth in Guangzhou area,and compare them with the values of Caucasian preterm infants in order to get insight into the bone development status of preterm infants in Guangzhou area and to evaluate the practicability of QUS.Methods The Omnisense quantitative ultrasound produced by Israel Sunlight company was used to measure the bone speed of sound(SOS) of left tibia of preterm infants born between Jun.2010 and Jun.2012 in Maternity and Children Health Hospital of Huadu District in Guangzhou,and the values of SOS of Caucasian preterm infants was compared.Results There were totally 1039 preterm infants born in Guangzhou area involved in this study,and they were divided into group A,B,C,D by gestational ages:≤ 30 weeks,30 + 1 ～ 32 weeks,32 + 1 ～ 34 weeks,34 + 1 ～ 36 + 6 weeks.The values of SOS of each group at birth were(2892.05 ± 139.17) m/s,(2936.84 ± 137.87) m/s,(2966.65 ± 116.60) m/s and (2988.63 ± 120.74) m/s,separately,and with the increase of gestational age,and there was significant difference of SOS between different gestational age groups(F =15.758,P =0.000).But there was no significant difference of SOS between male and female (F =2.665,P =0.103).Compared with Caucasian preterm infants,the SOS value gap (defined as the Z value) of preterm infants of different gestational age in Guangzhou area was no significant difference(P =0.117),and there was no significant difference between male and female (F =3.494,P =0.062).Conclusions The value of SOS of preterm infants was higher with the increase of maturity of preterm infants.There was no significant difference of SOS between Guangzhou preterm infants and Caucasian preterm infants.And QUS is suitable for clinical evaluation of bone development status of preterm infants.
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OBJECTIVES: Variations in sex hormones and the calcium balance can influence bone health in men. The present study aimed to examine the relationship between the calcaneal speed of sound and biochemical determinants of bone mass, such as sex hormones, parathyroid hormones and serum calcium. METHODS: Data from 549 subjects from the Malaysian Aging Male Study, which included Malay and Chinese men aged 20 years and older residing in the Klang Valley, were used for analysis. The subjects' calcaneal speed of sound was measured, and their blood was collected for biochemical analysis. Two sets of multiple regression models were generated for the total/bioavailable testosterone and estradiol to avoid multicollinearity. RESULTS: The multiple regression results revealed that bioavailable testosterone and serum total calcium were significant predictors of the calcaneal speed of sound in the adjusted model. After adjustment for ethnicity and body mass index, only bioavailable testosterone remained significant; the total serum calcium was marginally insignificant. In a separate model, the total testosterone and sex hormone-binding globulin were significant predictors, whereas the total serum calcium was marginally insignificant. After adjustment for ethnicity and body mass index (BMI), the significance persisted for total testosterone and SHBG. After further adjustment for age, none of the serum biochemical determinants was a significant predictor of the calcaneal speed of sound. CONCLUSION: There is a significant age-dependent relationship between the calcaneal speed of sound and total testosterone, bioavailable testosterone and sex hormone-binding globulin in Chinese and Malay men in Malaysia. The relationship between total serum calcium and calcaneal speed of sound is ethnicity-dependent.
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Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Young Adult , Calcaneus/physiology , Calcium/blood , Osteoporosis/diagnosis , Sound , Sex Hormone-Binding Globulin/analysis , Testosterone/blood , Body Mass Index , Bone Density/physiology , China , Estradiol/blood , Malaysia , Osteoporosis/blood , Osteoporosis/physiopathology , Predictive Value of Tests , Statistics, NonparametricABSTRACT
Introdução. A osteoporose é caracterizada por baixa massa óssea e alteração da microarquitetura, com diminuição da força óssea com aumento do risco de fraturas. Para avaliação da densidade mineral óssea a densitometria por absorciometria radiológica de dupla energia (DXA) é considerada o método padrão ouro. Porém, têm-se como desvantagens o alto custo e a falta de disponibilidade, sendo o ultrassom um método alternativo. Objetivo. Estimar a prevalência de fatores de risco de osteoporose em campanha de rastreamento populacional e avaliar a sua correlação com a ultrassonografia quantitativa de calcâneo. Método. Em campanha de prevenção e detecção da doença, na cidade de Curitiba, em 2009, voluntários foram cadastrados e foi aplicado um questionário sobre história mórbida atual e pregressa, obstétrica e ginecológica, fatores de risco de osteoporose e fratura e coleta de dados antropométricos. Realizaram-se exames com ultrassonografia quantitativa de calcâneo no aparelho Sonost-2000 (Osteosys), com avaliação de valores do T-score, sendo distribuídos em dois grupos, aqueles com T-score < -1.0 e T-score < -2,5 desvios-padrão da uma população de adultos jovens. Resultados. Dentre os 660 participantes da campanha, 388 participaram do estudo, 82,2% mulheres e 17,8% homens, média etária de 59 ± 12 anos. Entre as mulheres, 46,4% apresentaram ultrassonografia quantitativa de calcâneo sem anormalidades, 47,3% T-score <-1.0 e 6,3% T-score < -2,5. Entre os homens, em 58% não se detectaram anormalidades ao exame, 29% T-score <-1.0 e 13% T-score <-2.5. Os principais fatores de risco de diminuição da massa óssea encontrados foram redução da visão, tabagismo, queda no último ano, fraturas prévias e menopausa. Neste estudo, destaca-se como fator importante na prevenção da doença a prática de atividade física. Conclusão. A identificação de fatores de risco associados com a redução da massa óssea poderá auxiliar profissionais da área de saúde em selecionar pacientes com risco de osteoporose e osteopenia.
Introduction: Osteoporosis is characterized by low bone mass and changes in bone microarchitecture, with increased risk of fractures. Densitometry by dual energy X-ray absorptiometry (DXA) is considered the gold standard for evaluation of bone mineral density. However, it has the disadvantages of high cost and poor availability, with the ultrasound being an alternative method. Objective: To estimate the prevalence of risk factors for osteoporosis in a population screening study and to evaluate their correlation with calcaneal quantitative ultrasound. Method: During a campaign for prevention and detection of the disease in the city of Curitiba, in 2009, volunteers were enrolled and asked to answer a questionnaire on their obstetric and gynecological history, past medical history and history of present illness, risk factors for osteoporosis and fractures, and anthropometric data. Calcaneal quantitative ultrasound examinations were performed using Sonost-2000 (Osteosys), and T-score values were evaluated. Patients were then allocated into two groups: those with T-score < -1.0 and T-score < -2.5 standard deviations of a population of young adults. Results: Among the 660 participants in the campaign, 388 participated in the study. Of these participants, 82.2% were women and 17.8% were men; the mean age was 59 ± 12 years. Among the women, 46.4% showed normal calcaneal quantitative ultrasound, 47.3% presented T-score < -1.0 and 6.3% presented T-score < -2.5. Among men, 58% showed normal calcaneal quantitative ultrasound, 29% presented T-score < -1.0 and 13% presented T-score < -2.5. The main risk factors for reduced bone mass were found in cases of vision impairment, smoking, fall in the previous year, previous fractures, and menopause. In this study, it was found that physical activity was an important factor in preventing the disease. Conclusion: The identification of risk factors associated with low bone mass may assist health professionals in selecting patients at risk of developing osteoporosis and osteopenia.
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The purpose of this study was to develop a simple and easy predictive model of leg, spine and whole body bone mineral density (BMD) from anthropometric, physical fitness, body composition and quantitative ultrasound (QUS) variables. Participants were 138 Japanese overweight and obese men (50.9 ± 9.6 yr, body mass index [BMI] 29.1 ± 2.6 kg/m<sup>2</sup>). We measured anthropometric variables (height, weight, BMI, chest, waist, hip, upper arm, thigh circumferences), physical fitness (grip strength, side steps, vertical jump, forced vital capacity), body composition (fat-free mass) and QUS. BMD was measured by dual energy X-ray absorptiometry. Multiple linear regression analyses showed that all predictive models for BMD were significant. As a result, the predictive model for leg BMD showed the highest model fitting. The Bland & Altman approaches demonstrated the (positive or negative) systematic error even though most plots were placed within ideal range. Predictive model from physical fitness, body composition and QUS would be useful for estimating whole body and regional BMD. Because these predictive models are likely to have some systemic errors, further research is needed to improve the predictive accuracy.