Krieg Marc-Antoine, Cornuz Jacques, Ruffieux Christiane, Van Melle Guy, Büche Daniel, Dambacher Maximilian A, Hans Didier, Hartl Florian, Häuselmann Hansjorg J, Kraenzlin Marius, Lippuner Kurt, Neff Maurus, Pancaldi Pierro, Rizzoli Rene, Tanzi Franco, Theiler Robert, Tyndall Alan, Wimpfheimer Claus, Burckhardt Peter
Department of Internal Medicine, University Hospital, Lausanne, Switzerland.
J Bone Miner Res. 2006 Sep;21(9):1457-63. doi: 10.1359/jbmr.060615.
To compare the prediction of hip fracture risk of several bone ultrasounds (QUS), 7062 Swiss women > or =70 years of age were measured with three QUSs (two of the heel, one of the phalanges). Heel QUSs were both predictive of hip fracture risk, whereas the phalanges QUS was not.
As the number of hip fracture is expected to increase during these next decades, it is important to develop strategies to detect subjects at risk. Quantitative bone ultrasound (QUS), an ionizing radiation-free method, which is transportable, could be interesting for this purpose.
The Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk (SEMOF) study is a multicenter cohort study, which compared three QUSs for the assessment of hip fracture risk in a sample of 7609 elderly ambulatory women > or =70 years of age. Two QUSs measured the heel (Achilles+; GE-Lunar and Sahara; Hologic), and one measured the heel (DBM Sonic 1200; IGEA). The Cox proportional hazards regression was used to estimate the hazard of the first hip fracture, adjusted for age, BMI, and center, and the area under the ROC curves were calculated to compare the devices and their parameters.
From the 7609 women who were included in the study, 7062 women 75.2 +/- 3.1 (SD) years of age were prospectively followed for 2.9 +/- 0.8 years. Eighty women reported a hip fracture. A decrease by 1 SD of the QUS variables corresponded to an increase of the hip fracture risk from 2.3 (95% CI, 1.7, 3.1) to 2.6 (95% CI, 1.9, 3.4) for the three variables of Achilles+ and from 2.2 (95% CI, 1.7, 3.0) to 2.4 (95% CI, 1.8, 3.2) for the three variables of Sahara. Risk gradients did not differ significantly among the variables of the two heel QUS devices. On the other hand, the phalanges QUS (DBM Sonic 1200) was not predictive of hip fracture risk, with an adjusted hazard risk of 1.2 (95% CI, 0.9, 1.5), even after reanalysis of the digitalized data and using different cut-off levels (1700 or 1570 m/s).
In this elderly women population, heel QUS devices were both predictive of hip fracture risk, whereas the phalanges QUS device was not.
为比较几种骨超声（QUS）对髋部骨折风险的预测能力，对7062名年龄≥70岁的瑞士女性进行了三种QUS测量（两种测量足跟，一种测量趾骨）。足跟QUS均能预测髋部骨折风险，而趾骨QUS则不能。
由于预计在未来几十年髋部骨折的数量会增加，制定检测高危人群的策略很重要。定量骨超声（QUS）是一种无电离辐射且便于携带的方法，可能适用于此目的。
瑞士骨质疏松性骨折风险测量方法评估（SEMOF）研究是一项多中心队列研究，比较了三种QUS在7609名年龄≥70岁的老年门诊女性样本中评估髋部骨折风险的情况。两种QUS测量足跟（跟腱+；GE-通用电气医疗集团和Sahara；Hologic），一种测量足跟（DBM Sonic 1200；IGEA）。采用Cox比例风险回归估计首次髋部骨折的风险，对年龄、体重指数和中心进行调整，并计算ROC曲线下面积以比较不同设备及其参数。
在纳入研究的7609名女性中，对7062名年龄为75.2±3.1（标准差）岁的女性进行了为期2.9±0.8年的前瞻性随访。80名女性报告发生了髋部骨折。跟腱+的三个变量中，QUS变量每降低1个标准差，髋部骨折风险从2.3（95%置信区间，1.7，3.1）增加到2.6（95%置信区间，1.9，3.4）；Sahara的三个变量中，从2.2（95%置信区间，1.7，3.0）增加到2.4（95%置信区间，1.8，3.2）。两种足跟QUS设备的变量之间风险梯度无显著差异。另一方面，即使在对数字化数据进行重新分析并使用不同的截断水平（1700或1570米/秒）后，趾骨QUS（DBM Sonic 1200）也不能预测髋部骨折风险，调整后的风险比为1.2（95%置信区间，0.9，1.5）。
在这群老年女性中，足跟QUS设备均能预测髋部骨折风险，而趾骨QUS设备则不能。
