The Value Of Quantitative Ultrasound For Screening Bone Mass Abnormality In Elderly Population

Purpose:By comparing with the results of dual-energy X-ray absorptiometry——gold standard in the diagnosis of osteoporosis,the value of quantitative ultrasound technology for screening bone mass abnormality in the elderly will be evaluated.To explore whether the combined diagnosis experiment of QUS parameters,BMI index and OSTA index can improve the accuracy of QUS.Objects and Methods:318 elderly patients who were not diagnosed as OP in the geriatric ward,endocrine ward and physical examination center of our hospital from April to August 2019 were selected as subjects.Recorded the general information of each subjects and calculated BMI index and OSTA index.QUS was used to measure the BUA、SOS and T value of right heel;DXA was used to measure the BMD and T value of lumbar 1-4 and hip.The most sensitive and specific diagnostic thresholds for QUS to screen OP and osteopenia were found by using the receiver operating characteristic curves.The corresponding diagnostic sensitivity,specificity and area under the curve were calculated.Binary logistic regression equation was used to calculate the prediction probability of combined diagnosis for QUS-T,BUA,BMI and OSTA.ROC curve was used again to evaluate whether combined diagnosis could improve the screening accuracy of QUS.Outcomes: There were 318 subjects in this study,186 males(77.02±12.81 years old),accounting for 58.49%;132 females(70.10±10.95 years old),accounting for 41.51%.When screening OP in females with QUS,the best cut-off point of BUA was 54.27 d B/MHz,the best cut-off point of QUS-T was-1.62 SD,the best cut-off point of SOS was 1334.09m/s,the corresponding diagnostic sensitivity were 66.7%,66.7%,83.3%,and the specificity were 76.5%,76.5%,64.7%,respectively.When screening osteopenia in females with QUS,the best cutoff point of BUA was56.23 d B/MHz and the best cut-off point of QUS-T was-0.91 SD.The corresponding diagnostic sensitivity were 46.84% and 56.5%,the specificity were 75.4% and 62.3%,the AUC of SOS was 0.56 and 95% CI was 0.47～0.66.When QUS was used to screen OP in males,95% CI of all parameters included 0.5.When screening osteopenia in male with QUS,the best cut-off point of BUA was 61.50 d B/MHz and the best cut-off point of QUS-T was-1.20 SD.The corresponding diagnostic sensitivity were 72.7% and 72.7%,the specificity were 64.3% and 54.9%,the AUC of SOS was 0.49 and 95% CI was 0.37～0.60.The combined diagnosis predicted that the AUC of the joint diagnostic prediction probability in detecting OP in male was0.72 and 95% CI was 0.44～0.99;the AUC of prediction probability in detecting OP in female was 0.71,95% CI was 0.57～0.85.the AUC of prediction probability in detecting osteopenia in male was 0.68,95% CI was 0.5～0.78;the AUC of prediction probability in detecting osteopenia in female was 0.7,95% CI was 0.60～0.78.Conclusion:QUS can be used in primary medical institutions to screen OP and bone mass reduction in the elderly population.When using QUS to screen OP,QUS is more valuable in women than in men.Combined BMI index,OSTA index,BUA and QUS-T value of QUS can improve the screening accuracy of QUS for osteopenia in both elderly men and elderly women,but not for OP.