Määttä Mikko, Moilanen Petro, Timonen Jussi, Pulkkinen Pasi, Korpelainen Raija, Jämsä Timo
Department of Medical Technology, University of Oulu, Institute of Biomedicine, PO Box 5000, FI-90014 Oulu, Finland.
BMC Musculoskelet Disord. 2014 Jun 16;15:208. doi: 10.1186/1471-2474-15-208.
New methods for diagnosing osteoporosis and evaluating fracture risk are being developed. We aim to study the association between low-frequency (LF) axial transmission ultrasound and hip fracture risk in a population-based sample of older women.
The study population consisted of 490 community-dwelling women (78-82 years). Ultrasound velocity (V(LF)) at mid-tibia was measured in 2006 using a low-frequency scanning axial transmission device. Bone mineral density (BMD) at proximal femur measured using dual-energy x-ray absorptiometry (DXA) was used as the reference method. The fracture history of the participants was collected from December 1997 until the end of 2010. Lifestyle-related risk factors and mobility were assessed at 1997.
During the total follow-up period (1997-2010), 130 women had one or more fractures, and 20 of them had a hip fracture. Low V(LF) (the lowest quartile) was associated with increased hip fracture risk when compared with V(LF) in the normal range (Odds ratio, OR = 3.3, 95% confidence interval (CI) 1.3-8.4). However, V(LF) was not related to fracture risk when all bone sites were considered. Osteoporotic femoral neck BMD was associated with higher risk of a hip fracture (OR = 4.1, 95% CI 1.6-10.5) and higher risk of any fracture (OR = 2.4, 95% CI 1.6-3.8) compared to the non-osteoporotic femoral neck BMD. Decreased VLF remained a significant risk factor for hip fracture when combined with lifestyle-related risk factors (OR = 3.3, 95% CI 1.2-9.0).
Low V(LF) was associated with hip fracture risk in older women even when combined with lifestyle-related risk factors. Further development of the method is needed to improve the measurement precision and to confirm the results.
用于诊断骨质疏松症和评估骨折风险的新方法正在不断研发。我们旨在研究基于人群抽样的老年女性中，低频轴向传导超声与髋部骨折风险之间的关联。
研究人群包括490名社区居住女性（年龄在78 - 82岁之间）。2006年使用低频扫描轴向传导设备测量胫骨中部的超声速度（V(LF)）。使用双能X线吸收法（DXA）测量股骨近端的骨密度（BMD）作为参考方法。收集参与者自1997年12月至2010年底的骨折病史。1997年评估与生活方式相关的风险因素和活动能力。
在整个随访期（1997 - 2010年）内，130名女性发生过一次或多次骨折，其中20人发生髋部骨折。与正常范围的V(LF)相比，低V(LF)（最低四分位数）与髋部骨折风险增加相关（比值比，OR = 3.3，95%置信区间（CI）1.3 - 8.4）。然而，当考虑所有骨部位时，V(LF)与骨折风险无关。与非骨质疏松性股骨颈骨密度相比，骨质疏松性股骨颈骨密度与髋部骨折风险更高（OR = 4.1，95% CI 1.6 - 10.5）以及任何骨折风险更高（OR = 2.4，95% CI 1.6 - 3.8）相关。当与生活方式相关的风险因素相结合时，VLF降低仍是髋部骨折的显著风险因素（OR = 3.3，95% CI 1.2 - 9.0）。
即使与生活方式相关的风险因素相结合，低V(LF)仍与老年女性的髋部骨折风险相关。需要进一步改进该方法以提高测量精度并确认结果。
