Pluskiewicz W, Drozdzowska B
Department and Clinic of Internal and Allergic Diseases, Silesian Academy of Medicine, Katowice, Poland.
Osteoporos Int. 1999;10(1):47-51. doi: 10.1007/s001980050193.
The aim of this cross-sectional study was to assess the ability of quantitative ultrasound at the calcaneus to discriminate between fractured and unfractured men, fracture probability, and the relationship of ultrasonic parameters to age and body size. The study included 224 men (age range 36-86 years) with no history of diseases or therapy affecting bone metabolism. The subjects were divided into two groups (unfractured, n = 148; fractured, n = 76) matched for age and body size. Bone status was assessed by ultrasound measurements at the calcaneus. Long-term in vitro CV% values were 0.88% for speed of sound (SOS) and 0.54% for broadband ultrasound attenuation (BUA). In vivo CV% values were 0.33% for SOS and 2.48% for BUA, while sCV% values were 4.66% and 6.58%, respectively. The following SOS/BUA values were obtained: in unfractured men, SOS = 1517.5 +/- 35.3 m/s and BUA = 114.0 +/- 13.3 dB/MHz; in fractured men, SOS = 1492.6 +/- 24.6 m/s and BUA = 106.1 +/- 11.6 dB/MHz. The differences were significant (p<0.0001). The odds ratio for BUA for all fractures was 1.05 (95% CI, 0.03-2.07) and for SOS 2.13 (95% CI, 0.77-3.49). Only the age-related decrease in SOS in unfractured men was significant (r = -0.17, p<0.05). In fractured men, weight and body mass index (BMI) were found to correlate significantly with BUA (r = 0.31, p = 0.007, r = 0.31, p = 0.007, respectively). The areas under receiver operating characteristics (ROC) curves were 0.706 for SOS and 0.665 for BUA. Ultrasound measurements at the calcaneus thus enable discrimination between fractured and healthy males. Different patterns of the relationship between age and body size in the two groups suggest the presence of other, unknown factors affecting bone status. Their identification requires further prospective studies.
这项横断面研究的目的是评估跟骨定量超声鉴别男性骨折与未骨折情况的能力、骨折概率以及超声参数与年龄和体型的关系。该研究纳入了224名无影响骨代谢疾病或治疗史的男性（年龄范围36 - 86岁）。受试者按年龄和体型匹配分为两组（未骨折组，n = 148；骨折组，n = 76）。通过跟骨超声测量评估骨状态。声速（SOS）的长期体外变异系数（CV%）值为0.88%，宽带超声衰减（BUA）为0.54%。体内CV%值，SOS为0.33%，BUA为2.48%，而标准化CV%值分别为4.66%和6.58%。获得以下SOS/BUA值：未骨折男性中，SOS = 1517.5 ± 35.3米/秒，BUA = 114.0 ± 13.3分贝/兆赫；骨折男性中，SOS = 1492.6 ± 24.6米/秒，BUA = 106.1 ± 11.6分贝/兆赫。差异具有显著性（p<0.0001）。所有骨折的BUA比值比为1.05（95%可信区间，0.03 - 2.07），SOS为2.13（95%可信区间，0.77 - 3.49）。仅未骨折男性中与年龄相关的SOS下降具有显著性（r = -0.17，p<0.05）。在骨折男性中，发现体重和体重指数（BMI）与BUA显著相关（分别为r = 0.31，p = 0.007；r = 0.31，p = 0.007）。受试者工作特征（ROC）曲线下面积，SOS为0.706，BUA为0.665。因此，跟骨超声测量能够鉴别骨折男性与健康男性。两组中年龄与体型关系的不同模式表明存在其他影响骨状态的未知因素。对其进行识别需要进一步的前瞻性研究。
