폐경 후 여성에서 골다공증의 조기검진도구로서 골초음파의 유용성

Quantitative Ultrasound for Osteoporosis Screening in Postmenopausal Women

Objectives : To evaluate the diagnostic value of quantitative ultrasound (QUS) in the prediction of osteoporosis as defined by dual energy x-ray absorptiometry (DEXA) in postmenopausal women. Methods : Questionnaires and height and weight measurements were used in the investigation of 176 postmenopausal women. QUS measurements were taken on the right calcaneus while bone mineral density (BMD) measurements of the lumbar spine and femoral neck were made with DEXA. The areas under the curves (AUC) of the speed of sound (SOS) for osteoporosis in the lumbar spine and femoral neck were obtained through receiver operating characteristic (ROC) analysis and evaluated. A comparison was made, for osteoporosis in the lumbar spine and femoral neck, between the AUCs of the logistic model with clinical risk factors and SOS. Results : Pearson's correlation coefficients of SOS and lumbar spine BMD, and of SOS and femoral neck BMD were 0.26 and 0.37. The AUC for the logistic model in its discrimination for lumbar spine osteoporosis was 0.764, and for SOS 0.605. The AUCs for the logistic model in its discrimination for femoral neck osteoporosis and for SOS were 0.890 and 0.892, respectively. Conclusions : These results suggest that the diagnostic value of QUS as a screening tool for osteoporosis is moderate for the femoral neck, but merely low for the lumbar spine and that the predictability provided by SOS is no better than that by the sole use of clinical risk factors in postmenopausal women.