Use of Quantitative Ultrasound Calcaneus Measurement for Identifying Osteoporosis in Thai Working-aged Women
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Abstract
Background : The standard method for diagnosing osteoporosis is dual energy x-ray absorptiometry (DXA) at T-score threshold of ≤ -2.5 SD by WHO criteria. DXA is relatively expensive and non-portable. Quantitative ultrasound (QUS) has been developed for bone mineral density (BMD) measurement with cheaper cost, portable and free from radiation. There is no consensus regarding to its accuracy for identifying osteoporosis especially at threshold of Tscore ≤ -2.5.
Objective : To determine the diagnostic performance of calcaneal QUS at T-score ≤ -2.0 for osteoporosis screening in Thai working-aged woman and compare with use of OSTA index.
Material and method : An analytic cross-sectional study was conducted in 137 voluntary Thai women aged ≤60 years who worked in Chiang Mai. Demographic data, body weight, height were recorded. Lumbar spine BMD was measured by DXA. Calcaneal BMD was measured by QUS and converted to T-score. DXA T-score ≤ -2.5 or QUS T-score ≤ -2.0 were defined as “osteoporosis”. The OSTA index was calculated. Women with scores ≤ -1 or scores ≤ 0 were classified as “high risk”. Diagnostic test analysis was obtained to compare each method.
Results : Mean age of the women was 49.9 ± 4.9 years (range, 28-60). Most of them aged between 50-60 years (63.5%) and had BMI 18.6-25.0 (66.4%). Thirty-eight cases had OSTA index ≤ 0 (28.7%). The prevalence of osteoporosis was 10.9% (14 cases). Using lumbar spine DXA as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio for positive test of calcaneal QUS measurement were 93.3%, 59.0%, 21.9%, 98.6% and 2.78 respectively. These accuracy indices were higher than OSTA index except specificity. Threshold of OSTA index ≤ 0 showed more accuracy than ≤ -1
to classify the high risk group.
Conclusion : Calcaneal QUS measurement at T-score ≤ -2.0 is reliable for osteoporosis screening in Thai working-aged women. Its accuracy is more than use of OSTA index. Results of QUS alone do not exclude or confirm DXA-determined osteoporosis.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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