Bauer D C, Glüer C C, Cauley J A, Vogt T M, Ensrud K E, Genant H K, Black D M
Division of General Internal Medicine, University of California, San Francisco, USA.
Arch Intern Med. 1997 Mar 24;157(6):629-34.
Quantitative ultrasound of bone is a new radiation-free technique that measures bone mass and may assess bone quality. Retrospective studies have suggested that low-bone ultrasound of the calcaneus is associated with an increased risk for hip and other fractures in older women.
To establish the utility of calcaneal quantitative ultrasound of bone for the prediction of fractures and to compare quantitative ultrasound of bone with bone mineral densitometry by performing a prospective cohort study within the Study of Osteoporotic Fractures.
We studied 6189 postmenopausal women older than 65 years of 4 US clinical centers. Broadband ultrasound attenuation (BUA), a measurement of the differential attenuation of sound waves transmitted through the calcaneus, and bone mineral density of the calcaneus and hip were measured. Subsequent hip and other nonspine fractures were documented during a mean follow-up of 2.0 years.
In age- and clinic-adjusted analyses, each SD reduction in calcaneal BUA was associated with a doubling of the risk for hip fractures (relative risk [RR], 2.0; 95% confidence interval [CI], 1.5-2.7); a similar relationship was observed with bone mineral density of the calcaneus (RR, 2.2; 95% CI, 1.9-3.0) and femoral neck (RR, 2.6; 95% CI, 1.9-3.8). After adjustment for bone mineral density of the femoral neck, BUA was still associated with an increased risk for hip fracture (RR, 1.5; 95% CI, 1.0-2.1). Intertrochanteric fractures in particular were strongly associated with a low BUA measurement (RR, 3.3; 95% CI, 2.0-5.5).
Broadband ultrasound attenuation predicts the occurrence of fractures in older women and is a useful diagnostic test for osteoporosis. The strength of the association between BUA and fracture is similar to that observed with bone mineral density.
骨定量超声是一种新的无辐射技术，可测量骨量并可能评估骨质量。回顾性研究表明，老年女性跟骨的低骨超声与髋部及其他骨折风险增加有关。
通过在骨质疏松性骨折研究中进行前瞻性队列研究，确定跟骨定量超声在预测骨折方面的效用，并将骨定量超声与骨密度测定法进行比较。
我们研究了美国4个临床中心6189名65岁以上的绝经后女性。测量了宽带超声衰减（BUA），即通过跟骨传播的声波的差异衰减测量值，以及跟骨和髋部的骨密度。在平均2.0年的随访期间记录了随后发生的髋部及其他非脊柱骨折。
在年龄和诊所校正分析中，跟骨BUA每降低1个标准差，髋部骨折风险就会增加一倍（相对风险[RR]，2.0；95%置信区间[CI]，1.5 - 2.7）；跟骨骨密度（RR，2.2；95% CI，1.9 - 3.0）和股骨颈（RR，2.6；95% CI，1.9 - 3.8）也观察到类似关系。在调整股骨颈骨密度后，BUA仍与髋部骨折风险增加有关（RR，1.5；95% CI，1.0 - 2.1）。特别是转子间骨折与低BUA测量值密切相关（RR，3.3；95% CI，2.0 - 5.5）。
宽带超声衰减可预测老年女性骨折的发生，是骨质疏松症的一种有用诊断测试。BUA与骨折之间的关联强度与骨密度观察到的相似。
