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Age, gender, and fragility fractures are associated with differences in quantitative ultrasound independent of bone mineral density

Karlsson, M K; Duan, Y; Ahlborg, Henrik LU ; Obrant, Karl LU ; Johnell, Olof LU and Seeman, E (2001) In Bone 28(1). p.118-122
Abstract
Bone strength is determined by bone mineral density (BMD) and bone structure. Dual-energy X-ray absorptiometry (DXA) measures BMD. Whether quantitative ultrasound (qUS) measures a property of bone distinct from BMD is uncertain. To evaluate this, DXA and qUS were measured in 58 fracture patients and 428 controls. To study the independent effects of age and gender on qUS measurements and control for BMD by study design rather than statistical methods, subgroups from the normative database were created and intentionally matched by the same femoral neck (FN) BMD. Speed of sound (SOS; m/sec), broadband ultrasound attenuation (BUA; dB/MHz), and stiffness index (SI) were then compared in individuals matched by FN BMD but differing in age,... (More)
Bone strength is determined by bone mineral density (BMD) and bone structure. Dual-energy X-ray absorptiometry (DXA) measures BMD. Whether quantitative ultrasound (qUS) measures a property of bone distinct from BMD is uncertain. To evaluate this, DXA and qUS were measured in 58 fracture patients and 428 controls. To study the independent effects of age and gender on qUS measurements and control for BMD by study design rather than statistical methods, subgroups from the normative database were created and intentionally matched by the same femoral neck (FN) BMD. Speed of sound (SOS; m/sec), broadband ultrasound attenuation (BUA; dB/MHz), and stiffness index (SI) were then compared in individuals matched by FN BMD but differing in age, gender, and presence or absence of fractures. The results are presented as percentage difference (mean +/- SD). Elderly women with the same FN BMD as young women had 1 +/- 2% lower SOS (p < 0.05), 8 +/- 15% lower SI (p < 0.05), and 4 +/- 9% lower BUA (p = 0.07). Elderly women with the same FN BMD as elderly men had 5 +/- 9% lower BUA (p < 0.05). Elderly men with the same FN BMD as young men had 1 +/- 2% lower SOS (p = 0.1), 5 +/- 14% lower SI (p = 0.2), and 1 +/- 9% lower BUA (n.s.). Young women with the same FN BMD as young men had 2 +/- 7% lower BUA (n.s.). Women with fragility fractures had 8 +/- 11% lower BUA (p < 0.001) and 13 +/- 22% lower SI (p < 0.01) than controls with no fractures matched by FN BMD, age, and gender. Men with fragility fractures had 13 +/- 12% lower BUA (p < 0.01) and 16 +/- 19% lower SI (p < 0.05) than controls with no fractures matched by FN BMD, age, and gender. Despite comparable femoral neck BMD, qUS measurements differed according to age, gender, and fracture status, suggesting that qUS may provide additional information independent of femoral neck BMD, such as differences in connectivity or other properties yet to be identified. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone mineral density (BMD), Bone architecture, Dual-energy X-ray absorptiometry (DXA), Fractures, Quantitative ultrasound (QUS)
in
Bone
volume
28
issue
1
pages
118 - 122
publisher
Elsevier
external identifiers
  • pmid:11165952
  • scopus:0035142050
ISSN
1873-2763
DOI
10.1016/S8756-3282(00)00407-5
language
English
LU publication?
yes
id
d9c51e36-27b4-4f9b-9644-84b3b6638854 (old id 1121558)
date added to LUP
2008-07-01 11:26:15
date last changed
2018-10-03 11:22:16
@article{d9c51e36-27b4-4f9b-9644-84b3b6638854,
  abstract     = {Bone strength is determined by bone mineral density (BMD) and bone structure. Dual-energy X-ray absorptiometry (DXA) measures BMD. Whether quantitative ultrasound (qUS) measures a property of bone distinct from BMD is uncertain. To evaluate this, DXA and qUS were measured in 58 fracture patients and 428 controls. To study the independent effects of age and gender on qUS measurements and control for BMD by study design rather than statistical methods, subgroups from the normative database were created and intentionally matched by the same femoral neck (FN) BMD. Speed of sound (SOS; m/sec), broadband ultrasound attenuation (BUA; dB/MHz), and stiffness index (SI) were then compared in individuals matched by FN BMD but differing in age, gender, and presence or absence of fractures. The results are presented as percentage difference (mean +/- SD). Elderly women with the same FN BMD as young women had 1 +/- 2% lower SOS (p &lt; 0.05), 8 +/- 15% lower SI (p &lt; 0.05), and 4 +/- 9% lower BUA (p = 0.07). Elderly women with the same FN BMD as elderly men had 5 +/- 9% lower BUA (p &lt; 0.05). Elderly men with the same FN BMD as young men had 1 +/- 2% lower SOS (p = 0.1), 5 +/- 14% lower SI (p = 0.2), and 1 +/- 9% lower BUA (n.s.). Young women with the same FN BMD as young men had 2 +/- 7% lower BUA (n.s.). Women with fragility fractures had 8 +/- 11% lower BUA (p &lt; 0.001) and 13 +/- 22% lower SI (p &lt; 0.01) than controls with no fractures matched by FN BMD, age, and gender. Men with fragility fractures had 13 +/- 12% lower BUA (p &lt; 0.01) and 16 +/- 19% lower SI (p &lt; 0.05) than controls with no fractures matched by FN BMD, age, and gender. Despite comparable femoral neck BMD, qUS measurements differed according to age, gender, and fracture status, suggesting that qUS may provide additional information independent of femoral neck BMD, such as differences in connectivity or other properties yet to be identified.},
  author       = {Karlsson, M K and Duan, Y and Ahlborg, Henrik and Obrant, Karl and Johnell, Olof and Seeman, E},
  issn         = {1873-2763},
  keyword      = {Bone mineral density (BMD),Bone architecture,Dual-energy X-ray absorptiometry (DXA),Fractures,Quantitative ultrasound (QUS)},
  language     = {eng},
  number       = {1},
  pages        = {118--122},
  publisher    = {Elsevier},
  series       = {Bone},
  title        = {Age, gender, and fragility fractures are associated with differences in quantitative ultrasound independent of bone mineral density},
  url          = {http://dx.doi.org/10.1016/S8756-3282(00)00407-5},
  volume       = {28},
  year         = {2001},
}