RESEARCH - Prospective evaluation of risk of vetebral fractures using quantitative ultrasound measurements and BMD

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Ann Rheum Dis. Published Online First: 16 April 2008.

doi:10.1136/ard.2007.083618

--------------------------------------------------------------------------------

Extended Report

Prospective evaluation of risk of vertebral fractures using

quantitative ultrasound measurements and bone mineral density in a

population-based sample of postmenopausal women: Results of the Basel

Osteoporosis Study

R Hollaender 1*, F Hartl 1, M-A Krieg 2, A Tyndall 1, C Geuckel 3, C

Buitrago-Tellez 4, M Manghani 5, M Kraenzlin 6, R Theiler 7 and D Hans

8

1 Felix Platter Spital, University of Basel, Switzerland

2 Department of Internal Medicine, University of Lausanne, Switzerland

3 Imamed Radiologie Nordwest, Basel, Switzerland

4 Hightech Research Center, Institute of Radiology, Zofingen Hospital,

Switzerland

5 Felix Platter Hospital, University of Basel, Switzerland

6 Department of Endocrinology, University of Basel, Switzerland

7 Department of Rheumatology, City Hospital Triemli, Zurich, Switzerland

8 Nuclear Medicine Division, Geneva University Hospital, GenevA, Switzerland

Abstract

Introduction: Prospective studies have shown that Quantitative

Ultrasound (QUS) techniques predict the risk of fracture of the

proximal femur with similar standardized risk ratios to dual-energy

X-ray absorptiometry (DXA). Few studies have investigated these

devices for the prediction of vertebral fractures. The Basel

Osteoporosis Study (BOS) is a population-based prospective study to

assess the performance of QUS devices and DXA in predicting incident

vertebral fractures.

Methods: 432 women aged 60-80 years were followed-up for 3 years.

Incident vertebral fractures were assessed radiologically. Bone

measurements using DXA (spine and hip) and QUS measurements (calcaneus

and proximal phalanges) were performed. Measurements were assessed for

their value in predicting incident vertebral fractures using logistic

regression.

Results: QUS measurements at the calcaneus and DXA measurements

discriminated between women with and without incident vertebral

fracture, (20% height reduction). The relative risks (RRs) for

vertebral fracture, adjusted for age, were 2.3 for the Stiffness Index

(SI) and 2.8 for the Quantitative Ultrasound Index (QUI) at the

calcaneus and 2.0 for Bone Mineral Density (BMD) at the lumbar spine

..The predictive value (AUC (95% CI)) of QUS measurements at the

calcaneus remained highly significant (0.70 for SI, 0.72 for the QUI,

and 0.67 for DXA at the lumbar spine) even after adjustment for other

confounding variables.

Conclusion: QUS of the calcaneus and BMD measurements were shown to be

significant predictors of incident vertebral fracture. The RRs for QUS

measurements at the calcaneus are of similar magnitude as for DXA

measurements.

http://ard.bmj.com/cgi/content/abstract/ard.2007.083618v1?papetoc

--

Not an MD

[Guest guest]

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Thanks,

Patsy

<Rheumatoid.Arthritis.Support@...> wrote:

Ann Rheum Dis. Published Online First: 16 April 2008.

doi:10.1136/ard.2007.083618

----------------------------------------------------------

Extended Report

Prospective evaluation of risk of vertebral fractures using

quantitative ultrasound measurements and bone mineral density in a

population-based sample of postmenopausal women: Results of the Basel

Osteoporosis Study

R Hollaender 1*, F Hartl 1, M-A Krieg 2, A Tyndall 1, C Geuckel 3, C

Buitrago-Tellez 4, M Manghani 5, M Kraenzlin 6, R Theiler 7 and D Hans

8

1 Felix Platter Spital, University of Basel, Switzerland

2 Department of Internal Medicine, University of Lausanne, Switzerland

3 Imamed Radiologie Nordwest, Basel, Switzerland

4 Hightech Research Center, Institute of Radiology, Zofingen Hospital,

Switzerland

5 Felix Platter Hospital, University of Basel, Switzerland

6 Department of Endocrinology, University of Basel, Switzerland

7 Department of Rheumatology, City Hospital Triemli, Zurich, Switzerland

8 Nuclear Medicine Division, Geneva University Hospital, GenevA, Switzerland

Abstract

Introduction: Prospective studies have shown that Quantitative

Ultrasound (QUS) techniques predict the risk of fracture of the

proximal femur with similar standardized risk ratios to dual-energy

X-ray absorptiometry (DXA). Few studies have investigated these

devices for the prediction of vertebral fractures. The Basel

Osteoporosis Study (BOS) is a population-based prospective study to

assess the performance of QUS devices and DXA in predicting incident

vertebral fractures.

Methods: 432 women aged 60-80 years were followed-up for 3 years.

Incident vertebral fractures were assessed radiologically. Bone

measurements using DXA (spine and hip) and QUS measurements (calcaneus

and proximal phalanges) were performed. Measurements were assessed for

their value in predicting incident vertebral fractures using logistic

regression.

Results: QUS measurements at the calcaneus and DXA measurements

discriminated between women with and without incident vertebral

fracture, (20% height reduction). The relative risks (RRs) for

vertebral fracture, adjusted for age, were 2.3 for the Stiffness Index

(SI) and 2.8 for the Quantitative Ultrasound Index (QUI) at the

calcaneus and 2.0 for Bone Mineral Density (BMD) at the lumbar spine

..The predictive value (AUC (95% CI)) of QUS measurements at the

calcaneus remained highly significant (0.70 for SI, 0.72 for the QUI,

and 0.67 for DXA at the lumbar spine) even after adjustment for other

confounding variables.

Conclusion: QUS of the calcaneus and BMD measurements were shown to be

significant predictors of incident vertebral fracture. The RRs for QUS

measurements at the calcaneus are of similar magnitude as for DXA

measurements.

http://ard.bmj.com/cgi/content/abstract/ard.2007.083618v1?papetoc

--

Not an MD

---------------------------------

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