Stewart A, Felsenberg D, Eastell R, Roux C, Glüer C C, Reid D M
Osteoporosis Research Unit, Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, UK.
Bone. 2006 Sep;39(3):609-15. doi: 10.1016/j.bone.2006.02.072. Epub 2006 Apr 27.
There are many risk factors associated with low bone mineral density. Quantitative ultrasound (QUS) is a generally accepted method for measurement of bone and has been shown to be strongly associated with future fracture risk. The Osteoporosis and Ultrasound Study (OPUS) is a multi-centre European wide study examining 5 different QUS scanners (4 calcaneal, 1 finger device). The aim of this paper was to examine the relationship between risk factors (as assessed by questionnaire) and QUS measurements. 449 younger women (aged 20 to 39 years) and 2283 older women (aged 55 to 79 years) were included in this analysis. As expected, those with a self-reported previous fracture had lower QUS measurements than those without (P < 0.001). However, no significant difference was seen between those reporting a maternal hip fracture and those who did not report such an event. Differences were found for smokers vs. non-smokers for SOS but not for BUA measurements. Weight was positively correlated with all BUA variables but only with some SOS variables. We determined which risk factors were most strongly associated with QUS measurements by using step-wise multiple regression. Models for each QUS measurement were calculated, and the R2 values ranged from 0.18 to 0.28 for SOS, 0.27 to 0.32 for BUA and 0.31 to 0.42 for the finger QUS device. The most common risk factors across all models were age, use of hormone replacement therapy, self-reported previous fracture, self-reported diagnosis of osteoporosis, current weight, pulse rate and self-reported estimated height at age 20 years. We analysed relationships across the 5 centres and detected some geographical differences in the prevalence of the risk factors. In conclusion, similar relationships are seen with QUS measurements as are found for bone mineral density. However, the strength of the association is dependent on the type of QUS device and variable measured.
存在许多与低骨矿物质密度相关的风险因素。定量超声（QUS）是一种普遍认可的骨测量方法，并且已被证明与未来骨折风险密切相关。骨质疏松症与超声研究（OPUS）是一项欧洲范围内的多中心研究，检测了5种不同的QUS扫描仪（4种跟骨扫描仪，1种手指设备）。本文的目的是研究风险因素（通过问卷评估）与QUS测量值之间的关系。本分析纳入了449名年轻女性（年龄20至39岁）和2283名老年女性（年龄55至79岁）。正如预期的那样，自我报告曾有骨折的女性的QUS测量值低于未发生骨折的女性（P < 0.001）。然而，报告母亲曾发生髋部骨折的女性与未报告此类事件的女性之间未观察到显著差异。对于声速（SOS）测量值，吸烟者与非吸烟者之间存在差异，但对于宽带超声衰减（BUA）测量值则无差异。体重与所有BUA变量呈正相关，但仅与部分SOS变量呈正相关。我们通过逐步多元回归确定了哪些风险因素与QUS测量值关联最为紧密。计算了每种QUS测量值的模型，SOS的R2值范围为0.18至0.28，BUA为0.27至0.32，手指QUS设备为0.31至0.42。所有模型中最常见的风险因素包括年龄、激素替代疗法的使用、自我报告的既往骨折、自我报告的骨质疏松症诊断、当前体重、脉搏率以及自我报告的20岁时的估计身高。我们分析了5个中心之间的关系，并检测到风险因素患病率存在一些地理差异。总之，QUS测量值与骨矿物质密度呈现出相似的关系。然而，关联强度取决于QUS设备的类型和所测量的变量。
