Camozzi Valentina, De Terlizzi Francesca, Zangari Monica, Luisetto Giovanni
Department of Medical and Surgical Sciences, Division of Endocrinology, University of Padua, Padua, Italy.
Ultrasound Med Biol. 2007 Jul;33(7):1039-45. doi: 10.1016/j.ultrasmedbio.2007.01.002. Epub 2007 Apr 18.
Phalangeal and calcaneal quantitative ultrasound (QUS) measurements were tested in a postmenopausal osteoporotic population of a wide age range to assess their ability to identify subjects with vertebral fractures in a population of postmenopausal women with osteoporosis. A group of 127 osteoporotic women aged from 50 to 85 y, who had been postmenopausal for at least 5 y, were enrolled. All subjects underwent phalangeal and calcaneal QUS measurements, femoral neck and lumbar spine dual energy X-ray absorptiometry (DXA) measurements and lateral thoracic and lumbar spine radiography. Osteoporosis was defined on the basis of femoral neck or lumbar spine bone mineral density (BMD) T-score lower than -2.5 SD or of the presence of one or more vertebral atraumatic fractures, independently of BMD values. Fifty-two women had one or more vertebral fractures, while the remaining 75 had no evidence of previous fracture. Both QUS techniques were able to discriminate between fractured and nonfractured subjects in the whole group (p < 0.05). When patients aged <70 y (n = 43) and patients aged > or = 70 y (n = 84) were considered separately, phalangeal QUS and lumbar spine BMD were able to discriminate vertebral fractures in the younger group (p < 0.05), whereas calcaneal QUS was able to discriminate vertebral fractures in the older one (p < 0.05). The results of this study raise an issue of the optimal use of different QUS techniques and different skeletal sites in the management of osteoporosis in early or late postmenopausal life.
在年龄范围广泛的绝经后骨质疏松症人群中，对指骨和跟骨定量超声（QUS）测量进行了测试，以评估其在绝经后骨质疏松症女性人群中识别椎体骨折患者的能力。招募了一组127名年龄在50至85岁之间、绝经至少5年的骨质疏松症女性。所有受试者均接受了指骨和跟骨QUS测量、股骨颈和腰椎双能X线吸收法（DXA）测量以及胸部和腰椎侧位X线摄影。骨质疏松症的定义基于股骨颈或腰椎骨密度（BMD）T值低于-2.5标准差，或存在一处或多处椎体非创伤性骨折，与BMD值无关。52名女性有一处或多处椎体骨折，其余75名没有既往骨折的证据。两种QUS技术均能够在整个组中区分骨折和未骨折的受试者（p<0.05）。当分别考虑年龄<70岁的患者（n=43）和年龄≥70岁的患者（n=84）时，指骨QUS和腰椎BMD能够区分较年轻组中的椎体骨折（p<0.05），而跟骨QUS能够区分较年长组中的椎体骨折（p<0.05）。本研究结果提出了在绝经后早期或晚期骨质疏松症管理中不同QUS技术和不同骨骼部位最佳应用的问题。
