Pulse-echo Ultrasound Identifies Caucasian and Hispanic Women at Risk for Osteoporosis

Abstract

Background: Pulse-echo ultrasonography (PEUS) is a novel ultrasound method that measures the thickness of cortical bone at peripheral skeletal sites with a handheld device connected to a personal computer using proprietary software. Previous studies have shown a significant correlation between density index (DI), a PEUS-derived parameter, and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry at the hip. DI thresholds that discriminate patients likely to have osteoporosis with 90% sensitivity and 90% specificity have been established in a population of Caucasian women in Finland and validated in a study of predominately Caucasian women in the state of Minnesota in the USA. The DI thresholds have not previously been evaluated in non-Caucasian populations. Methodology: This study aimed to determine whether previously established DI thresholds in Caucasian women require adjustment in Hispanic women. PEUS measurements at the proximal tibia and dual-energy X-ray absorptiometry BMD at the hip were evaluated in Caucasian and Hispanic women at a single investigative site in Albuquerque, New Mexico, USA. DI was calculated for each patient and compared with BMD. The performance of DI threshold values for these populations was compared. Results: The study enrolled 293 postmenopausal women (153 Caucasian, 140 Hispanic) with and without osteoporosis. The sensitivity and specificity for DI thresholds to distinguish women with total hip or femoral neck T-score ≤ -2.5 or > -2.5 was similar in Caucasians (sensitivity 80%, specificity 86%) and Hispanics (sensitivity 80%, specificity 91%). Conclusions: The findings of this study confirm the utility of previously established DI thresholds to identify women who are likely or unlikely to have osteoporosis and suggest that the same thresholds can be used for postmenopausal Caucasian and Hispanic women.