Gonçalves Ezequiel M, Sewaybricker Leticia E, Baptista Fatima, Silva Analiza M, Carvalho Wellington R G, Santos Allan O, de Mello Maricilda P, Lemos-Marini Sofia H V, Guerra Gil
Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil; Pediatric Endocrinology Unit, Pediatrics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil; PhD Student Program in Child and Adolescent Health.
Ultrasound Med Biol. 2014 Jul;40(7):1414-9. doi: 10.1016/j.ultrasmedbio.2013.12.027. Epub 2014 Apr 13.
The purpose of this study was to verify the performance of quantitative ultrasound (QUS) parameters of proximal phalanges in the evaluation of reduced bone mineral density (BMD) in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21 OHD). Seventy patients with 21 OHD (41 females and 29 males), aged between 6-27 y were assessed. The QUS measurements, amplitude-dependent speed of sound (AD-SoS), bone transmission time (BTT), and ultrasound bone profile index (UBPI) were obtained using the BMD Sonic device (IGEA, Carpi, Italy) on the last four proximal phalanges in the non-dominant hand. BMD was determined by dual energy X-ray (DXA) across the total body and lumbar spine (LS). Total body and LS BMD were positively correlated to UBPI, BTT and AD-SoS (correlation coefficients ranged from 0.59-0.72, p < 0.001). In contrast, when comparing patients with normal and low (Z-score < -2) BMD, no differences were found in the QUS parameters. Furthermore, UBPI, BTT and AD-SoS measurements were not effective for diagnosing patients with reduced BMD by receiver operator characteristic curve parameters. Although the AD-SoS, BTT and UBPI showed significant correlations with the data obtained by DXA, they were not effective for diagnosing reduced bone mass in patients with 21 OHD.
本研究的目的是验证近端指骨定量超声（QUS）参数在评估21-羟化酶缺乏症（21 OHD）所致先天性肾上腺皮质增生症患者骨密度（BMD）降低中的性能。对70例年龄在6至27岁之间的21 OHD患者（41例女性和29例男性）进行了评估。使用BMD Sonic设备（意大利卡尔皮的IGEA公司）在非优势手的最后四个近端指骨上获得QUS测量值，即振幅依赖声速（AD-SoS）、骨传播时间（BTT）和超声骨轮廓指数（UBPI）。通过双能X线（DXA）测定全身和腰椎（LS）的骨密度。全身和LS的骨密度与UBPI、BTT和AD-SoS呈正相关（相关系数范围为0.59至0.72，p<0.001）。相比之下，在比较骨密度正常和低（Z评分<-2）的患者时，QUS参数未发现差异。此外，根据受试者工作特征曲线参数，UBPI、BTT和AD-SoS测量值对诊断骨密度降低的患者无效。尽管AD-SoS、BTT和UBPI与DXA获得的数据显示出显著相关性，但它们对诊断21 OHD患者的骨质减少无效。
