Damilakis J, Papadokostakis G, Perisinakis K, Hadjipavlou A, Gourtsoyiannis N
Department of Medical Physics, Faculty of Medicine, University of Crete, PO Box 1393, 71409 Iraklion, Crete, Greece.
Osteoporos Int. 2003 Aug;14(8):688-93. doi: 10.1007/s00198-003-1420-5. Epub 2003 Jul 24.
The purpose of this study was to investigate the clinical usefulness of forearm bone mineral density (BMD) and speed of sound (SOS) at the phalanx and radius as pre-selection tests to identify women with low BMD at the axial skeleton. BMD was measured by dual-energy X-ray absorptiometry (DXA) in the forearm, lumbar spine and femoral neck. SOS at the radius and phalanx was measured using a multisite quantitative ultrasound (QUS) device. Measurements were performed on 524 consecutive women referred for the assessment of BMD. Women with a T-score <-1 and T-score < or =-2.5 at either spine or femoral neck were identified, and T-score cut-off values for the forearm DXA and QUS variables were determined. Cut-off values for the forearm BMD estimated to detect normal women and those with T-score <-1 at the axial skeleton identified a total of 82% of subjects with 91% certainty. Cut-off values for the forearm BMD determined to detect women with T-score >-2.5 and those with osteoporosis allowed the identification of 62% of the study population with 90% certainty. Cut-off values for the phalangeal and radial SOS estimated to detect normal women and those with T-score <-1 at the axial skeleton identified a total of 49% and 1% of subjects, respectively. Cut-off values estimated for QUS variables to detect women with T-score >-2.5 and those with osteoporosis at the axial skeleton either failed to detect subjects with sufficient certainty (phalangeal SOS) or detected a negligible percentage of patients (radial SOS). In conclusion, forearm BMD may be used as a pre-selection test to identify women with low BMD at the axial skeleton, thus enabling reduction of the number of women who need axial BMD assessment. SOS of the phalanges and radius appears to have less value in the detection of the women with low axial BMD.
本研究的目的是调查前臂骨矿物质密度（BMD）以及指骨和桡骨的声速（SOS）作为预筛选测试，用于识别轴向骨骼骨密度低的女性的临床实用性。通过双能X线吸收法（DXA）测量前臂、腰椎和股骨颈的骨密度。使用多部位定量超声（QUS）设备测量桡骨和指骨的声速。对连续524名因骨密度评估前来就诊的女性进行了测量。确定了脊柱或股骨颈T值<-1以及T值≤-2.5的女性，并确定了前臂DXA和QUS变量的T值截断值。估计用于检测正常女性以及轴向骨骼T值<-1的女性的前臂骨密度截断值，以91%的确定性识别出了82%的受试者。确定用于检测T值>-2.5的女性和患有骨质疏松症的女性的前臂骨密度截断值，以90%的确定性识别出了62%的研究人群。估计用于检测正常女性以及轴向骨骼T值<-1的女性的指骨和桡骨声速截断值，分别识别出了49%和1%的受试者。估计用于检测轴向骨骼T值>-2.5的女性和患有骨质疏松症的女性的QUS变量截断值，要么未能以足够的确定性检测出受试者（指骨声速），要么检测出的患者比例可忽略不计（桡骨声速）。总之，前臂骨密度可作为预筛选测试，用于识别轴向骨骼骨密度低的女性，从而减少需要进行轴向骨密度评估的女性数量。指骨和桡骨的声速在检测轴向骨密度低的女性方面似乎价值较小。
