Screening with ultrasound of the heel may contribute to the prevention in osteoporosis

Objective:To calibrate a Quantitative Ultrasonography(QUS)system against densitometryby defining the sensitivity and specificity of the method,and to propose a series of QUS interpre-tation thresholds to classify the individual risk with regards to the risk of developing osteoporosisin later life.Methods:Subjects were recruited in New York City over a 1-year period.Women with amen-orrhea for at least 12 months were defined as postmenopausal,and all other women as premeno-pausal.Bone mineral density(BMD)was measured with a dual energy X-ray absorptiometer(DXA)and QUS performed with the calcaneus of broadband ultrasound attenuation(BUA)andspeed of sound(SOS)using the Lunar Achilles system.Statistical analysis was performed usingSPSS software Version 10.0.Results:Two hundred twenty-eight premenopausal and menopausal women were recruited.Most of the participants were Hispanic,Caucasian and African-American in this study.All thesubjects had DXA and QUS examined and T-score was got from both.The statistical resultsshowed that the T-score of QUS has a significant relationship with that of DXA(spine:r=0.557,P<0.0001;femur:r=0.611,P<0.0001).Both QUS and DXA T-score has a significant andnegative relationship with age(QUS:r=-0.241,P<0.0001;Spine:r=-0.277,P<0.0001;femur:-0.296,P<0.0001).When T-score of heel ultrasound -1.5 was set as the interpreta-tion threshold,the osteoporosis patients with T-score of DXA-femur scan(100%)and DXA-spine(77.10%)less than -2.5 were detected.As well,the specificities of T-score -1.5 ofQUS for DXA-femur and DXA-spine were 67.5% and 72.8%,respectively.In addition,if we set-1.0 of T-score of QUS as the cutoff,74.80% and 79.60% of the osteopenia based on DXA ofspine and femur were identified.The specificities were 59.4% and 57.7%.Conclusions:QUS of the calcaneus may be an effective method for providing risk stratifica-tion for osteoporosis,and for the closely associated future risk for fragility-fracture.