McLeod Katherine M, Johnson Shanthi, Rasali Drona, Verma Ashok
Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada; Saskatchewan Population Health and Evaluation Research Unit, University of Regina, Regina, Saskatchewan, Canada.
Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada; Saskatchewan Population Health and Evaluation Research Unit, University of Regina, Regina, Saskatchewan, Canada.
J Clin Densitom. 2015 Apr-Jun;18(2):157-64. doi: 10.1016/j.jocd.2015.02.006.
The objective of this cross-sectional study was to evaluate the accuracy of the calcaneal quantitative ultrasound (QUS) and the Osteoporosis Self-Assessment Tool (OST) in identifying older women with osteoporosis as defined by dual-energy X-ray absorptiometry (DXA), and to establish optimal cutoffs to determine risk. We assessed bone mineral density of the femoral neck and lumbar spine using DXA and subsequent calcaneal QUS and OST measurements in 174 women aged 50-80 years. Pearson product correlation coefficients between QUS, OST, and DXA parameters were calculated. Receiver operating characteristic curves were constructed and areas under the curves (AUCs) and optimal thresholds for QUS and OST were defined based on sensitivity, specificity, and likelihood ratio analysis. The ability of calcaneal QUS to identify women with a T-score ≤-2.5 at the femoral neck (AUC = 0.892) consistently outperformed a T-score ≤-2.5 at the lumbar spine (AUC = 0.696) and OST at both the femoral neck and lumbar spine (AUC = 0.706-0.807). Stiffness index cutoff values that fall between 65 and 78 were found to warrant DXA screening, with a cutoff <65 indicating high likelihood of osteoporosis. Further prospective research is needed to examine the gender-related differences of QUS and OST diagnostic performance and their usefulness in clinical practice.
这项横断面研究的目的是评估跟骨定量超声（QUS）和骨质疏松症自我评估工具（OST）在识别按照双能X线吸收法（DXA）定义的骨质疏松老年女性方面的准确性，并确定用于判定风险的最佳临界值。我们使用DXA评估了174名年龄在50至80岁之间女性的股骨颈和腰椎骨密度，随后进行了跟骨QUS和OST测量。计算了QUS、OST和DXA参数之间的Pearson积差相关系数。构建了受试者工作特征曲线，并基于敏感性、特异性和似然比分析确定了QUS和OST的曲线下面积（AUC）及最佳阈值。跟骨QUS识别股骨颈T值≤ -2.5女性的能力（AUC = 0.892）始终优于腰椎T值≤ -2.5（AUC = 0.696）以及股骨颈和腰椎的OST（AUC = 0.706 - 0.807）。发现刚度指数临界值在65至78之间时需要进行DXA筛查，临界值<65表明骨质疏松的可能性很高。需要进一步开展前瞻性研究，以检验QUS和OST诊断性能的性别差异及其在临床实践中的实用性。
