Orgee J M, Foster H, McCloskey E V, Khan S, Coombes G, Kanis J A
Department of Human Metabolism and Clinical Biochemistry, University of Sheffield Medical School, UK.
Osteoporos Int. 1996;6(1):1-7. doi: 10.1007/BF01626530.
We assessed a method for the measurement of ultrasound velocity in cortical bone of the human tibia using a probe designed to minimize the effects of surrounding soft tissues. Of four different measurement values, the maximum velocity (average of the five highest readings) gave the lowest errors of reproducibility in relation to the population variance (standardized coefficient of variation = 1.8%). The maximum velocity varied according to the tibial site measured and for practical reasons the mid-tibial site was chosen for further study. The short-term intra- and inter-observer reproducibilities (coefficients of variation) were 0.35% (n = 22) and 0.50% (n = 27) respectively. Long-term reproducibility over 4 months in 31 subjects was 0.68%. There was no significant difference in maximum ultrasound velocity between the dominant and nondominant tibia in 78 women (3764 +/- 209 vs 3763 +/- 199 m/s). Tibial ultrasound velocity was significantly higher in 73 premenopausal women (3999 +/- 102 m/s) than in 129 women referred for assessment of postmenopausal osteoporosis (3780 +/- 168 m/s), 26 women with steroid-induced osteoporosis (3790 +/- 188 m/s) and 4 women with hyperparathyroidism (3575 +/- 261 m/s). In premenopausal women, ultrasound velocity did not correlate significantly with age, height, weight or body mass index. In women with postmenopausal osteoporosis, ultrasound velocity decreased with age after the menopause (r = -0.47, p < 0.0001) and body weight exerted a weaker protective effect. The apparent annual decrease in velocity with age in postmenopausal osteoporosis (8.5 m/s) was comparable to the error of reproducibility. We conclude that the technique for measuring tibial ultrasound velocity is highly reproducible in relation to the distribution of values in the population and is sensitive to age- and osteoporosis-induced changes in bone. Further studies are required to examine its relationship to other indices of skeletal status to determine the biological and clinical relevance of the technique.
我们评估了一种测量人胫骨皮质骨中超声速度的方法，该方法使用了一个旨在将周围软组织影响降至最低的探头。在四个不同的测量值中，最大速度（五个最高读数的平均值）相对于总体方差的再现性误差最低（标准化变异系数 = 1.8%）。最大速度根据测量的胫骨部位而变化，出于实际原因，选择胫骨中部进行进一步研究。观察者内和观察者间的短期再现性（变异系数）分别为0.35%（n = 22）和0.50%（n = 27）。31名受试者在4个月内的长期再现性为0.68%。78名女性优势胫骨和非优势胫骨的最大超声速度无显著差异（3764 +/- 209 vs 3763 +/- 199 m/s）。73名绝经前女性的胫骨超声速度（3999 +/- 102 m/s）显著高于129名因绝经后骨质疏松症接受评估的女性（3780 +/- 168 m/s）、26名患有类固醇性骨质疏松症的女性（3790 +/- 188 m/s）和4名患有甲状旁腺功能亢进症的女性（3575 +/- 261 m/s）。在绝经前女性中，超声速度与年龄、身高、体重或体重指数无显著相关性。在绝经后骨质疏松症女性中，绝经后超声速度随年龄下降（r = -0.47，p < 0.0001），体重发挥较弱的保护作用。绝经后骨质疏松症中速度随年龄的明显年下降（8.5 m/s）与再现性误差相当。我们得出结论，测量胫骨超声速度的技术相对于人群中的值分布具有高度再现性，并且对年龄和骨质疏松症引起的骨骼变化敏感。需要进一步研究以检查其与骨骼状态其他指标的关系，以确定该技术的生物学和临床相关性。
