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Quantitative Ultrasound Technique for the Assessment of Osteoporosis and Prediction of Fracture Risk
Osteoporosis in men and women is increasingly recognised as an important health issue. Bone mineral density (BMD) and hone strength appears to he major determinants of osteoporotic fracture. Measurement of hone strength by ultrasound is found to be a competitive means of measuring osteoporotic fracture risk and provide additional information about bone's structure and composition. In the present work quantitative ultrasound assessment of osteoporosis is carried out in Indian men and women by measuring broadband ultrasound attenuation (BUA) and speed of sound (SOS) through calcaneum bone to provide a clinical measure called the stiffness index (SI). The SI is the sum of the scaled and normalised BUA and SOS values, which is a measure of bone strength and is sensitive to bone structure used to predict the risk of bone fracture due to osteoporosis. Measurement of SI is carried out in 283 men, 108 premenopausal and 85 postmenopausal women. SI results expressed as T-score and Z-score are used to assist the physicians in the diagnosis of osteoporosis. The presence of osteoporosis is defined as T-score lower than -2.5. Observation shows that osteoporosis is predominant in postmenopausal women population who are at greater risk of fracture compared to premenopausal women and men. The effect of age, weight, height and body mass index (BMI) on SI in men and women is analyzed. The SI has negative correlation with age and is found to be a significant factor in both men and women with a high percentage of bone mineral loss in early menopausal women. In univariate analysis body weight and BMI have moderate positive correlation with SI in men and women. Height seems to have no significant effect on SI. There is a rapid loss of bone mineral content leading sudden decrease in SI during the first five years after menopause and it continues to decrease at a lesser rate with increasing age.
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