Authors: M Y Chan N D Nguyen J R Center J A Eisman T V Nguyen
Publish Date: 2012/08/10
Volume: 24, Issue: 3, Pages: 1015-1022
Abstract
This study sought to determine the association between calcaneal quantitative ultrasound QUS and fracture risk in individuals without osteoporosis according to the World Health Organization criteria ie BMD Tscore −25 We found that calcaneal QUS is an independent predictor of fracture risk in women with nonosteoporotic bone mineral density BMDMore than 50 of women and 70 of men who sustain a fragility fracture have BMD above the osteoporotic threshold Tscore −25 Calcaneal QUS is associated with fracture risk This study aimed to test the hypothesis that low calcaneal QUS is associated with increased fracture risk in individuals with nonosteoporotic BMDWe included 312 women and 390 men aged 62–90 years with BMD Tscore −25 at femoral neck QUS was measured in broadband ultrasound attenuation BUA at the calcaneus using a CUBA sonometer BMD was measured at the femoral neck FNBMD by dual energy Xray absorptiometry using GE Lunar DPXL densitometer The incidences of any fragility fracture were ascertained by Xray reports during the followup period from 1994 to 2011Of the 702 participants 26 of women n = 80/312 and 14 of men n = 53/390 experienced at least one fragility fracture during the followup period In women after adjusting for covariates increased risk of any fracture was significantly associated with decreased BUA HR = 150 95 CI 113–199 Compared with that of FNBMD the models with BUA in women had greater AUC 071 085 071 for any hip and vertebral fracture respectively and yielded a net reclassification improvement of 164 P = 0009 when combined with FNBMD In men BUA was not significantly associated with fracture risk before and after adjustmentWe gratefully acknowledge the assistance of Sr Janet Watters Donna Reeves and Shaye Field for the interview data collection and measurement of bone mineral density We also appreciate the invaluable help of the staff of Dubbo Base Hospital We thank Mr J McBride Dania Mang and the IT group of the Garvan Institute of Medical Research for the management of the database The study was partly supported by the Australia National Health and Medical Research Council NDN is supported by a fellowship from the AMBeR Australian Medical Bioinformatics Resource TVN is supported by a senior research fellowship from the Australian National Health and Medical Research CouncilProfessor JA Eisman has served as consultant on the Scientific Advisory Board for Amgen Eli Lilly Merck Sharp Dohme Novartis SanofiAventis Servier and deCode He was the editorinchief for the Journal of Bone and Mineral Research from 2003 to 2007 and was a committee member of Department of Health and Aging Australian Government and Royal Australasian College of General Practitioners Dr Jacqueling R Center has given educational talks for Eli Lilly Merck Sharp and Dohme and SanofiAventis Professor TV Nguyen has received honorarium for consulting and speaking in symposia sponsored by MSD Roche Servier SanofiAventis and Novartis Other authors have no conflicts of interest
Keywords: