van Daele P L, Burger H, Algra D, Hofman A, Grobbee D E, Birkenhäger J C, Pols H A
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
J Bone Miner Res. 1994 Nov;9(11):1751-7. doi: 10.1002/jbmr.5650091112.
Broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the os calcis were measured in a sample of 1405 persons (628 men), aged 55-93 years, from the cohort of the Rotterdam Study, a population-based study of diseases in the elderly. We studied the effect of age, body mass index, age at menopause, current use of thiazides, loop diuretics, and estrogens, smoking, and disability on SOS and BUA. Comparisons were made between ultrasound measurements and bone mineral density (BMD) measurements of the lumbar spine and proximal femur using DXA. We found a significant decline with age in SOS and BUA in men (-0.4 and -0.1 %/year, respectively) and women (-1.3 and -0.4%/year, respectively), which persisted after adjustment for body mass index. Age at menopause was not associated with SOS or BUA. Pack-years of smoking was negatively related to SOS in both sexes and to BUA in men. Severe disability was associated with lower SOS and BUA in men, but not in women. Despite the small number of exposed persons, current corticosteroid use was associated with lower BUA in men. The other risk factors examined did not affect the ultrasound measurements. We observed modest correlations between SOS or BUA, on the one hand, and BMD of the lumbar spine, on the other hand (r = 0.32-0.42). Similar correlations were found between ultrasound measurements and BMD measurements of the proximal femur. We conclude that in persons 55 years or over (1) there is a significant age-related decline of BUA and SOS, which is about three times higher in women compared with men, and (2) ultrasound measurements are not able to predict low BMD in hip or spine.
在鹿特丹研究队列中，对1405名年龄在55至93岁之间的人群（628名男性）的跟骨进行了宽带超声衰减（BUA）和声速（SOS）测量，该队列是一项基于人群的老年人疾病研究。我们研究了年龄、体重指数、绝经年龄、当前噻嗪类利尿剂、襻利尿剂和雌激素的使用情况、吸烟以及残疾对SOS和BUA的影响。使用双能X线吸收法（DXA）对腰椎和股骨近端的超声测量结果与骨密度（BMD）测量结果进行了比较。我们发现，男性（分别为每年-0.4%和-0.1%）和女性（分别为每年-1.3%和-0.4%）的SOS和BUA随年龄显著下降，在调整体重指数后这种下降仍然存在。绝经年龄与SOS或BUA无关。吸烟包年数在男女中均与SOS呈负相关，在男性中与BUA呈负相关。严重残疾与男性较低的SOS和BUA相关，但与女性无关。尽管暴露人群数量较少，但当前使用皮质类固醇与男性较低的BUA相关。所研究的其他危险因素未影响超声测量结果。我们观察到，一方面SOS或BUA与另一方面腰椎BMD之间存在适度相关性（r = 0.32 - 0.42）。在超声测量结果与股骨近端BMD测量结果之间也发现了类似的相关性。我们得出结论，在55岁及以上人群中：（1）BUA和SOS存在与年龄相关的显著下降，女性下降幅度约为男性的三倍；（2）超声测量不能预测髋部或脊柱的低骨密度。
