Background Bone mineral density (BMD) as measured by dual-energy X-ray absorptiometry (DXA) is considered the gold standard for the management of osteoporosis. Recently, quantitative ultrasound (QUS), which is easy to use, inexpensive, portable, does not use ionizing radiation, and has also been shown to provide information about bone quality and to predict fracture risk, has gained growing interest in this area.
Objectives The aim of this study was to compare the capability of one-third radius (33% radius) DXA BMD measurements and calcaneal QUS (cQUS) variables for identifying axial osteoporosis as measured by DXA in men.
Methods Axial BMD measurements at the lumbar spine and at the hip (femoral neck and total hip), 1/3 radius BMD of the non-dominant forearm were made using DXA and cQUS variables at both sides as measured twice were obtained in 179 men aged between 24 and 85 years. Osteoporosis was defined based on the WHO criteria in men aged 50 and over, a man having been considered as osteoporotic in the presence of a T-score ≤-2.5 in any of the axial regions measured. For defining axial osteoporosis or BMD below the expected range for age, Z-scores of ≤-2.0 were used in men younger than the age of 50 years. Receiver operating characteristic (ROC) analysis was used to assess the osteoporosis identification capability of measurements.
Results The areas under ROC curves (AUCs) for 1/3 radius BMD, its T-score, the lowest means (as calculated as the mean of the two calcaneal QUS measurements for each heel) of quantitative ultrasound index (QUI), QUI T-score, broadband ultrasound attenuation (BUA), speed of sound (SOS), and estimated heel BMD (eBMD) for identifying axial osteoporosis or BMD below the expected range were found as 0.755, 0.767, 0.760, 0.758, 0.717, 0.768, and 0.764 (p<0.001 for all), respectively.
Conclusions In conclusion, AUCs pointed to similar (for QUI, QUI T-score, and eBMD) or even better (for SOS) osteoporosis discriminative capability of cQUS variables in comparison to radial DXA BMD variables. These findings may have implications that cQUS variables, particularly SOS, may be used for the identification of osteoporosis in men whose axial BMD cannot be measured by DXA due to certain circumstances as well as in circumstances where DXA is not available.
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Disclosure of Interest None declared