Schott A M, Weill-Engerer S, Hans D, Duboeuf F, Delmas P D, Meunier P J
INSERM U234, Hôpital Edouard Herriot, Lyon, France.
J Bone Miner Res. 1995 Feb;10(2):243-9. doi: 10.1002/jbmr.5650100210.
We measured the heels of 43 women who had recently sustained a hip fracture and 86 age matched controls, using an Achilles ultrasound device. Average BUA, SOS, and Stiffness were significantly lower in fractured patients (p < 0.0001). We also estimated ultrasound parameters for patients as a function of controls and found the mean BUA to be -1.09 SD compared with controls, the mean SOS -0.89 SD, and the mean Stiffness -0.98 SD. Femoral BMD measured at the neck, Ward's triangle, and the trochanter with a DPX Plus was also significantly lower in fractured patients (p < 0.0001). The increased risk of hip fracture associated with low ultrasound values was estimated with logistic regression analysis for each bone parameter, adjusted for height and weight. The adjusted regression coefficients associated with BUA, SOS, Stiffness, and BMD were all significant (p < 0.0001) demonstrating the influence of all ultrasound and DXA parameters on the risk of hip fracture. After adjusting the logistic regressions for BMD neck, BUA, SOS, and Stiffness were still significant independent predictors of hip fracture. Sensitivity and specificity of all measures were analyzed with the area under the ROC curve which were for BUA, 0.77 +/- 0.04; for SOS, 0.75 +/- 0.04; for Stiffness, 0.78 +/- 0.04; and for BMD, 0.74 +/- 0.04. We determined the range for the best compromise between sensitivity and specificity of BUA, 97-98 dB/MHz; SOS, 1482-1487 m/s; Stiffness 59-62% Young Adult; and of BMD, 0.64-0.69 g/cm2. The area under the ROC curves of BUA, SOS, Stiffness, and DXA were compared and no statistically significant difference was found.(ABSTRACT TRUNCATED AT 250 WORDS)
我们使用跟腱超声设备测量了43名近期发生髋部骨折的女性以及86名年龄匹配的对照者的足跟情况。骨折患者的平均宽带超声衰减（BUA）、声速（SOS）和硬度显著更低（p < 0.0001）。我们还根据对照者估算了患者的超声参数，发现与对照者相比，平均BUA为 -1.09标准差，平均SOS为 -0.89标准差，平均硬度为 -0.98标准差。使用DPX Plus测量的股骨颈、沃德三角区和大转子处的骨密度在骨折患者中也显著更低（p < 0.0001）。通过对每个骨参数进行逻辑回归分析，并对身高和体重进行校正，评估了与低超声值相关的髋部骨折风险增加情况。与BUA、SOS、硬度和骨密度相关的校正回归系数均具有显著性（p < 0.0001），表明所有超声和双能X线吸收法（DXA）参数对髋部骨折风险均有影响。在对逻辑回归进行骨密度颈、BUA、SOS和硬度校正后，它们仍是髋部骨折的显著独立预测因素。使用ROC曲线下面积分析了所有测量指标的敏感性和特异性，其中BUA为0.77±0.04；SOS为0.75±0.04；硬度为0.78±0.04；骨密度为0.74±0.04。我们确定了在敏感性和特异性之间达到最佳折衷的范围，BUA为97 - 98 dB/MHz；SOS为1482 - 1487 m/s；硬度为59 - 62%青年成人；骨密度为0.64 - 0.69 g/cm²。比较了BUA、SOS、硬度和DXA的ROC曲线下面积，未发现统计学上的显著差异。（摘要截断于250字）
