Quantitative ultrasound and vertebral fracture in postmenopausal southern Chinese women

Abstract

Quantitative Ultrasound (QUS) has recently been demonstrated to be able to evaluate fracture risk in osteoporotic patients. We evaluated the broadband, ultrasound attenuation (BUA), speed of sound (SOS) and stiffness (Quantitative Ultrasound Index, QUI) in 391 osteoporotic women with recent vertebral fractures using a waterless calcaneal ultrasound system (Sahara, Hologic, USA). Bone mineral density (BMD) at the spine and hip was determined by dual X ray absorptiometry (QDR 2000 plus, Hologic). Their results were compared to a group of 256 non-osteoporotic subjects. After adjustment for age, the relative risk (RR) of vertebral fracture for one standard deviation (SO) reduction was 1.9 (95% confidence interval 1.3-2.5) for BUA, 3.4 (1.9-6.0) for SOS and 1.8 (1.3-2.5) for QUI. A similar relation was observed with BMD at the spine (RR 3.6 (2.0-6.8) and at the hip (RR 2.6 (1.6 - 4.3). Adjustment for spine or hip BMD did not significantly alter the relation between BUA and vertebral fracture. e.g. after adjustment for spinal BMD, the RR of vertebral fracture for 1 SO reduction was 1.6 (1.1-2.4) for BUA, 2.6 (1.4-4.8) for SOS and 1.6 (1.2-2.3) for QUI. In conclusion, the relation between QUS parameters and vertebral fracture is similar to that observed for BMD and vertebral fracture. Our data suggest that QUS is a useful tool in the prediction of vertebral fractures.