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. 2021 Aug 3;11(1):15709.
doi: 10.1038/s41598-021-95261-7.

Pre-screening for osteoporosis with calcaneus quantitative ultrasound and dual-energy X-ray absorptiometry bone density

Chia-Chi Yen  1   2   3 , Wei-Chun Lin  4 , Tzu-Hao Wang  1 , Guan-Fan Chen  1 , Da-Ying Chou  1 , Dian-Min Lin  1 , Shu-Yuan Lin  1 , Min-Ho Chan  1   3 , Jia-Ming Wu  5 , Chin-Dar Tseng  6 , Yu-Jie Huang  7 , Tsair-Fwu Lee  8   9
Affiliations

Pre-screening for osteoporosis with calcaneus quantitative ultrasound and dual-energy X-ray absorptiometry bone density

Chia-Chi Yen et al. Sci Rep. .

Abstract

Calcaneal quantitative ultrasonography (QUS) is a useful prescreening tool for osteoporosis, while the dual-energy X-ray absorptiometry (DXA) is the mainstream in clinical practice. We evaluated the correlation between QUS and DXA in a Taiwanese population. A total of 772 patients were enrolled and demographic data were recorded with the QUS and DXA T-score over the hip and spine. The correlation coefficient of QUS with the DXA-hip was 0.171. For DXA-spine, it was 0.135 overall, 0.237 in females, and 0.255 in males. The logistic regression model using DXA-spine as a dependent variable was established, and the classification table showed 66.2% accuracy. A receiver operating characteristic (ROC) analyses with Youden's Index revealed the optimal cut-off point of QUS for predicting osteoporosis to be 2.72. This study showed a meaningful correlation between QUS and DXA in a Taiwanese population. Thus, it is important to pre-screen for osteoporosis with calcaneus QUS.

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Conflict of interest statement

The authors declare that there are no conflicts of interest. Part result of this study has been submitted in an abstract form at Phenma 2020.

Figures

Figure 1
Figure 1
(A) Histogram of calcaneus QUS T-score data. (B) Histogram of the SOS data by QUS machine. (C) Histogram of the BUA data by QUS machine. Figure linework and aesthetics were created in R 3.6.2; link to software homepage. QUS_T quantitative ultrasonography T-score, SOS speed of sound, BUA broadband ultrasound attenuation.
Figure 2
Figure 2
(A) Histogram of DXA-Hip data. (B) Histogram of DXA-Spine data. Figure linework and aesthetics were created in R 3.6.2; link to software homepage. DXA-Hip dual-energy X-ray absorptiometry of Hip, DXA-Spine dual-energy X-ray absorptiometry of Spine.
Figure 3
Figure 3
(A) Scatter plot and regression line of calcaneus QUS_T and DXA-Hip of male osteoporosis. (B) Scatter plot and regression line of calcaneus QUS_T and DXA-spine of male osteoporosis. (C) Scatter plot and regression line of calcaneus QUS_T and DXA-Hip of female osteoporosis. (D) Scatter plot and regression line of calcaneus QUS_T and DXA-spine of female osteoporosis. Figure linework and aesthetics were created in R 3.6.2; link to software homepage. QUS_T quantitative ultrasonography T-score, DXA-Hip dual-energy X-ray absorptiometry of Hip, DXA-Spine dual-energy X-ray absorptiometry of Spine.
Figure 4
Figure 4
ROC curve analysis using QUS as predictive variable. The test result variable(s) = QUS_T has at least one tie between the positive actual state group and the negative actual state group. Statistics may be biased. Figure linework and aesthetics were created in R 3.6.2; link to software homepage. ROC curve receiver operating characteristic curve, sensitivity measures the proportion of actual positives that are correctly identified, 1-specificity missed diagnosis rate, QUS_T quantitative ultrasonography T-score.
Figure 5
Figure 5
The ROC curve analysis of probability calculated from logistic regression model as predictive variable. Figure linework and aesthetics were created in R 3.6.2; link to software homepage. ROC Curve receiver operating characteristic curve, QUS_T quantitative ultrasonography T-score, sensitivity measures the proportion of actual positives that are correctly identified, 1-specificity missed diagnosis rate.
Figure 6
Figure 6
ROC curve analysis with coordinates for calculating the Youden’s index. Figure linework and aesthetics were created in R 3.6.2; link to software homepage. Youden's J single statistic that captures the performance of a dichotomous diagnostic test, QUS quantitative ultrasonography.
Figure 7
Figure 7
Ten-fold cross validation of the logistic regression model.
See this image and copyright information in PMC

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