Quantitative Ultrasound Measurements Research Articles

Assessment of hepatic fat content in using quantitative ultrasound measurement of hepatic/renal ratio and hepatic echo-intensity attenuation rate.

This study aims to evaluate and validate a simple quantitative ultrasound (US) method for determining the hepatic fat content (HFC) based on the combination of quantitative US hepatic/renal ratio (US-HRR) and quantitative US hepatic echo-intensity attenuation rate (US-HAR) as compared with [1H]-magnetic resonance spectroscopy (1H-MRS). There were a total of 242 subjects recruited in the present study. All subjects were examined for HFC by quantitative US and 1H-MRS methods. The QUS-HRR and QUS-HAR were calculated from ordinary ultrasound images of liver and kidney with a triple modality 3D abdominal phantom using the Image J software. The results found that US-HRR and US-HAR correlated with 1H-MRS HFC (US-HRR: r=0.946, p<0.001; US-HAR: r=0.936, p<0.001). The equation for HFC prediction by using quantitative US was: HFC (%) = 28.965 × US-HRR + 218.045 × US-HAR - 8.892. Subgroup analysis in study subjects with body mass index (BMI) ≥28 showed that quantitative US HFC was associated with 1H-MRS HFC (R2=0.953, p<0.001). Receiver operating characteristic (ROC) analysis observed that the cut-off value of fatty liver diagnosis was 6.71% in using the quantitative US model; the sensitivity and specificity for fatty liver diagnosis were 94.15% and 96.30%, respectively. Variability analysis indicated that there was a relative high degree of consistency in the measurement of HFC with different operators or ultrasonic apparatus. Quantitative US measurement could be regarded as a simple, sensitive tool to accurately assess HFC. It provides a valid alternative to 1H-MRS as an easy, non-invasive option for the precise estimation of HFC in clinical practice.

Defining disease progression in Chinese mainland people: Association between bone mineral density and knee osteoarthritis.

ObjectiveTo evaluate change in bone mineral density (BMD) during development of knee osteoarthritis (OA) in elderly Chinese community residents. Further, to monitor disease progression by recording speed of sound (SOS), one parameter of BMD provided by quantitative ultrasound measurement.MethodsA total of 4173 community residents of the Chinese mainland were organized to complete questionnaires and relevant measurements, including anthropometry, radiology and quantitative ultrasound (QUS). SOS measurements of the distal radius were acquired using QUS measurements. The Kellgren-Lawrence (KL) grade of knee OA was evaluated by two experienced radiographers using X-rays. Finally, a general linear models analysis was performed to determine potential relationships. Further, the area under the receiver operating characteristic curve (ROC AUC) was applied to assess the distinction model.ResultsThe SOS score in the OA group was significantly lower than that in the control group (p ​< ​0.001). However, after adjustment for age and body mass index (BMI), no significant difference was observed in the male population (p ​＝ ​0.841), while a significantly lower SOS score presented in knee OA participants in the female population (p ​＝ ​0.033). A turning point in SOS scores, from increasing to decreasing trends, occurred around KL grade 2; the SOS score gradually increased with progression in participants from KL grades 0 to 2, whereas the SOS score presented a significant decrease in participants with KL grades 3 and 4. The AUC for the model to distinguish OA progression was 0.891.ConclusionThere was a non-linear and stage-specific association between SOS score and knee OA, which presented a positive relationship in early stages, but a negative relationship in advanced stages. A decline of SOS score in knee OA patients in early stages should alert clinicians to the possibility of disease progression.The Translational potential of this articleIn the present study, the relationship between OA and BMD had established by SOS. The results suggested that close monitoring of SOS in elderly Chinese communities residents with knee OA could alert disease progression involvement by an easily accessible method, and help early referral to orthopedist consultation for further examination and treatment.

Associations of plasma YKL-40 concentrations with heel ultrasound parameters and bone turnover markers in the general adult population.

YKL-40, also known as chitinase-3-like protein 1, is a new proinflammatory biomarker, that might play a role in tissue remodeling and bone resorption. Here we evaluated the associations of the YKL-40 plasma concentration with heel ultrasound parameters and bone turnover markers (BTMs) in adult men and women from the general population. We tested for a causal role of YKL-40 on bone metabolism using published single nucleotide polymorphisms (SNPs) with consequences for YKL-40 expression and function. Data were obtained from two population-based cohorts: the Study of Health in Pomerania (SHIP) and SHIP-Trend. Quantitative ultrasound (QUS) measurements at the heel were performed and bone turnover was assessed by measurement of intact amino-terminal propeptide of type I procollagen (PINP) and carboxy-terminal telopeptide of type I collagen (CTX). Associations between the YKL-40 plasma concentration and the QUS-based parameters, bone turnover marker (BTM) concentrations and 44 SNPs, including the lead SNP rs4950928, were evaluated in 382 subjects. Furthermore, we assessed the associations between the same SNPs and the QUS-based parameters (n=5777) or the BTM concentrations (n=7190). Sex-specific linear regression models adjusted for a comprehensive panel of interfering covariantes revealed statistically significant inverse associations between YKL-40 and all QUS-based parameters as well as positive associations with CTX in women. The rs4950928 polymorphism was associated with YKL-40 in men and women but none of the tested SNPs was associated with the QUS-based parameters or the BTMs after correction for multiple testing. Plasma YKL-40 concentrations are associated with QUS-based parameters as well as CTX concentrations in women but these associations are probably not causal.

VP62.05: Quantitative ultrasound measurement of endometrial waves in abrnormal uteri: interim results of the WAVES study

VP62.05: Quantitative ultrasound measurement of endometrial waves in abrnormal uteri: interim results of the WAVES study

Associação da espessura do quadríceps com a área de secção transversa do reto femoral, força muscular e velocidade da marcha de pacientes críticos

Objetivo: Verificar se há relação entre a espessura muscular do quadríceps femoral (EMQ) com a área de secção transversa (AST) do reto femoral, força muscular periférica e velocidade da marcha em pacientes críticos. Métodos: Estudo transversal realizado na unidade de terapia intensiva adulto de um hospital terciário na região Sul do Brasil. A EMQ e a AST do reto femoral foram mensuradas a partir de imagens ultrassonográficas do quadríceps femoral, cuja avaliação foi realizada nas primeiras 24 horas de ventilação mecânica. A força muscular periférica foi avaliada por meio da pontuação obtida na escala Medical Research Council no momento do despertar do paciente. A velocidade da marcha foi mensurada através do teste de velocidade de marcha de 6 metros na alta hospitalar. Resultados: A amostra foi composta por 28 pacientes (46±18 anos, 20 do sexo masculino). A EMQ apresentou correlação positiva e forte com a AST do reto femoral (r=0,708; p0,0001) e correlação positiva e moderada com a velocidade da marcha (r=0,627; p=0,003). Na análise multivariada, evidenciou-se que a AST do reto femoral foi a variável preditora independente da EMQ (β=0,14; p=0,003). Conclusão: O estudo demonstrou que a EMQ apresentou associação com a AST do reto femoral e com a velocidade da marcha de pacientes críticos nos momentos avaliados. Além disso, a AST do reto femoral foi um preditor independente da EMQ. Tais resultados são clinicamente relevantes pelo fato de descreverem a aplicabilidade precoce de medidas ultrassonográficas quantitativas no cenário do paciente crítico, bem como a relação com desfechos funcionais.

Pilot clinical study of quantitative ultrasound spectroscopy measurements of erythrocyte aggregation within superficial veins.

BACKGROUND:An enhanced inflammatory response is a trigger to the production of blood macromolecules involved in abnormally high levels of erythrocyte aggregation.OBJECTIVE:This study aimed at demonstrating for the first time the clinical feasibility of a non-invasive ultrasound-based erythrocyte aggregation quantitative measurement method for potential application in critical care medicine.METHODS:Erythrocyte aggregation was evaluated using modeling of the backscatter coefficient with the Structure Factor Size and Attenuation Estimator (SFSAE). SFSAE spectral parameters W (packing factor) and D (mean aggregate diameter) were measured within the antebrachial vein of the forearm and tibial vein of the leg in 50 healthy participants at natural flow and reduced flow controlled by a pressurized bracelet. Blood samples were also collected to measure erythrocyte aggregation ex vivo with an erythroaggregometer (parameter S10).RESULTS:W and D in vivo measurements were positively correlated with the ex vivo S10 index for both measurement sites and shear rates (correlations between 0.35–0.81, p < 0.05). Measurement at low shear rate was found to increase the sensitivity and reliability of this non-invasive measurement method.CONCLUSIONS:We behold that the SFSAE method presents systemic measures of the erythrocyte aggregation level, since results on upper and lower limbs were highly correlated.

Associations of Sex Steroids With Changes in Calcaneal Quantitative Ultrasound Measurements: A Longitudinal Study in Chinese Male Adolescents

This 2-year longitudinal study aimed to detect the associations of sex steroids, sex hormone-binding globulin with bone parameters and the changes thereof in Chinese male adolescents. A total of 642 male students aged 12–16 years from a secondary school in Jiangmen, China, were included. Total testosterone (T), total oestradiol (E2), and sex hormone-binding globulin were measured by chemiluminescence immunoassay. The bioavailable T (BioT) and E2 (BioE2) were calculated. The speed of sound, broadband ultrasound attenuation, and stiffness index of the right heel were measured by Sahara Clinical Bone Sonometer at both baseline and 2-year follow-up. The confounding effects of age, height, weight, pubertal stage, physical activity, energy-adjusted dietary calcium intake, and dietary vitamin D intake were adjusted. The baseline value of each bone parameter was also adjusted in the longitudinal analysis. Results showed that total T and BioT were positively associated with bone parameters and changes in them (β = 0.076–0.115, p < 0.05). A threshold effect of BioT on broadband ultrasound attenuation, stiffness index and their changes were also observed. Positive associations between BioT and bone mass gain were observed only in individuals with BioT levels <240.0 ng/dl (β = 0.088–0.131, p < 0.05). Moreover, total E2 or BioE2 were found to be inversely associated with speed of sound and its change (β = −0.109 to –0.077, p < 0.05). This study supported that in Chinese male adolescents, serum T was a positive predictor for bone formation with a threshold effect, and E2 could have influence on the changes in bone architecture during puberty. These findings may improve the understanding of the effects of sex steroids on the acceleration of bone formation in male adolescents and provide useful information for the prediction model establishment of peak bone mass.

Liver Shear Wave Speed and Other Quantitative Ultrasound Measures of Liver Parenchyma: Prospective Evaluation in Healthy Children and Adults.

OBJECTIVE. The purpose of this study was to use 2D ultrasound shear wave elastography (SWE) to define expected ranges for liver shear wave speed and shear wave dispersion in children and adults without a known history of liver disease. The study also sought to define liver attenuation in adults. SUBJECTS AND METHODS. This was an institutional review board-approved prospective study of 128 children (younger than 18 years old) and 32 adults without liver disease who underwent 2D SWE of the liver with a Canon Aplio i800 ultrasound system (i8CX1 transducer). Ten shear wave speed and shear wave dispersion measurements were obtained. In adults, five attenuation measurements were also obtained. Pearson correlation and t tests were used to define relationships between shear wave speed and dispersion values and predictor variables. Multivariable logistic regression with forward selection was used to generate models. RESULTS. Median age was 5.04 years old for the pediatric participants and 48.92 years old for the adult participants. Mean median shear wave speed and shear wave dispersion were 1.29 ± 0.13 m/s and 11.43 ± 1.75 (m/s)/kHz, respectively, for the pediatric participants and 1.32 ± 0.13 m/s and 10.24 ± 1.65 (m/s)/kHz, respectively, for the adults. Mean median attenuation in adults was 0.52 ± 0.11 dB/cm/MHz. On multivariable modeling, height was the only significant predictor of shear wave speed in children (0.0012 m/s per cm, p < 0.0001) and abdominal wall thickness was the only predictor of shear wave speed in adults (0.12 m/s per cm, p = 0.0008). CONCLUSION. Liver shear wave speed and shear wave dispersion data for children and adults without liver disease provides data against which results from patients with liver disease can be compared. Liver shear wave speed increases during childhood associated with increases in height and shear wave speed increases in adulthood with increasing abdominal wall thickness.

The Correlation of Quantitative Ultrasound Measures and Supraspinatus Tendon Quality: A Pilot Study.

Background:The objective of this study was to determine the feasibility of assessing tendon quality as quantified by histology through changes in quantitative ultrasound measures.Methods:Eight cadaveric shoulders (four with a small supraspinatus tendon tear) were examined using conventional B-mode ultrasound in the transverse plane by internally rotating and hyperextending the humerus. Quantitative ultrasound measures (skewness, kurtosis, variance, and echogenicity) were calculated based on the grayscale distribution of the ultrasound image taken of the supraspinatus tendon near the insertion site. The specimens were then dissected to the supraspinatus tendon where tendon biopsies were taken near the insertion site, mid-substance, and myotendinous junction. Through histology, tendon quality was evaluated based on collagen fiber organization, fatty infiltration, nuclei shape, and cellularity. Correlations between quantitative ultrasound measures and histological grades of tendon quality were determined through Pearson or Spearman's rho correlations.Results:A total of three significant correlations between quantitative ultrasound measures and histological parameters of tendon quality were found. Significant correlations between kurtosis and cellularity at the insertion site (r = 0.724) (P < 0.05) as well as variance and fatty infiltration at the myotendinous junction (ρ = −0.843) (P < 0.05) and for the whole tendon (ρ = −0.826) (P < 0.05) were found.Conclusion:The results show the potential for quantitative ultrasound measures to assess factors of tendon quality that can only be determined through histology. With further development of the methodology that utilizes quantitative ultrasound measures, clinicians might be able to evaluate the tendon quality noninvasively in future.

Effects of Home Exercises on Shoulder Pain and Pathology in Chronic Spinal Cord Injury: A Randomized Controlled Trial.

The aims of this study were to replicate findings that a home exercise program intervention improved shoulder pain and function and to assess changes in supraspinatus tendon pathology associated with the home exercise program in persons with chronic spinal cord injury. The study is a single-blind randomized controlled trial. Individuals with spinal cord injury of at least 1 yr and chronic shoulder pain of moderate or greater average intensity were enrolled. Participants were randomized to a 12-wk home exercise program consisting of strengthening and stretching exercises or to an education-only control group, with immediate postintervention and 4-wk postintervention (16 wks) follow-ups. The main outcome measures were self-report measures of shoulder pain and impairment, the Physical Examination of the Shoulder Scale, quantitative ultrasound metrics of the supraspinatus tendon, and the Ultrasound Shoulder Pathology Rating Scale. Thirty-two participants were randomized to home exercise program or education-only control condition. The mean ± SD age was 44.8 ± 12.5; 81.3% were male; 65.6% had motor complete paraplegia. Using a per-protocol, within-group analysis method, significant differences were observed between baseline and postintervention for the home exercise program group for the least pain intensity (P = 0.02), number of days with shoulder pain (P = 0.042), Physical Examination of the Shoulder Scale scores (dominant side, P = 0.036; nondominant side, P = 0.008), the Disabilities of the Arm, Shoulder, and Hand (P = 0.028), and the Patient Global Impression of Change (P = 0.015). The education-only control condition group demonstrated significant changes in average unpleasantness of shoulder pain after the intervention period (P = 0.049). Comparisons in changes from baseline between groups showed that the home exercise program group had greater improvements in nondominant-side Physical Examination of the Shoulder Scale scores and global impression of change, whereas the education-only control condition group had greater improvements in depressive symptoms.For quantitative ultrasound measures, no significant changes were found with within-group analyses for the home exercise program group, although the education-only control condition group demonstrated a decrease in tendon width in the nondominant-side supraspinatus tendon (P = 0.036). Comparison of changes between groups suggests that the education-only control condition group had a greater increase in dominant shoulder supraspinatus tendon ultrasound contrast at the end of the study. Changes in several measures of shoulder pain and function occurred after the home exercise program intervention, although the magnitude of changes was only significantly greater than those of the education-only control condition group for two measures. Significant changes in supraspinatus pathology were not detected with quantitative ultrasound metrics.

Comparison of calcaneal quantitative ultrasound and bone densitometry parameters as fracture risk predictors in type 2 diabetes mellitus

To investigate the utility of calcaneal quantitative ultrasound compared with bone densitometry (DXA) in predicting incident low-trauma fracture in type 2 diabetes. This retrospective cohort study included a subset of participants in the Dubbo Osteoporosis Epidemiology Study who had concurrent calcaneal quantitative ultrasound and DXA measurement, comprising 809 people without type 2 diabetes and 96 with type 2 diabetes. Fracture data had been collected prospectively. Cox proportional hazard models and receiver operating curves (ROC) were used to compare calcaneal quantitative ultrasound and DXA parameters as predictors for any low-trauma fracture. The median age of participants was 71years (IQR 68-76, 50% men) for those without type 2 diabetes and 70 years (IQR 68-76, 55% men) for those with type 2 diabetes. There was no difference in low-trauma fracture incidence between groups when stratified by sex. In those without type 2 diabetes, the hazard ratio for fracture per 1 sd decrease in broadband ultrasound attenuation and femoral neck bone mineral density (BMD) was 1.47 [95% confidence interval (CI) 1.26-1.71] and 1.39 (95% CI 1.17-1.64), respectively. The corresponding figures in type 2 diabetes were 1.81 (95% CI 1.03-3.19) for broadband ultrasound attenuation and 2.55 (95% CI 1.28-5.08) for femoral neck BMD. Broadband ultrasound attenuation is comparable with femoral neck BMD as a predictor for low trauma incident fracture in type 2 diabetes. Calcaneal quantitative ultrasound offers several advantages over DXA and should be considered in further studies of bone health screening or in clinical practice where DXA is unavailable.

Trabecular bone score and bone quantitative ultrasound in Spanish postmenopausal women. The Camargo Cohort Study

ObjectiveTo evaluate trabecular bone score (TBS) in Spanish postmenopausal women from our area. To analyze its relationship with bone mineral density (BMD), bone quantitative ultrasound (QUS) and serum concentrations of 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (PTH) and bone turnover markers. Study designA total of 1450 postmenopausal women aged 44–94 (62 ± 10) participated in this cross-sectional study nested in a population-based cohort. BMD and TBS were assessed by DXA. QUS measurements were performed using a Sahara Clinical Sonometer. Serum 25(OH)D, PTH, P1NP, β-CTX were determined by electrochemiluminescence. ResultsMean TBS of postmenopausal women in our region was 1.341 ± 0.111. Nearly 50 % of them had normal values. Only 11 % had scores compatible with a clearly degraded microarchitecture. TBS decreased with age, correlated negatively with BMI and was lower in current smokers than in non-smokers. An association was observed between TBS and QUS, although the association was weak and lower than that found between TBS and BMD or QUS and BMD. No association was found between TBS and 25(OH)D, PTH or bone turnover markers. ConclusionsHalf of postmenopausal women in our region have TBS values that indicate a preserved microarchitecture. Only about 10 % have scores compatible with a clearly degraded microarchitecture. A weak association was observed between TBS and QUS, suggesting that the two techniques capture different aspects of bone microarchitecture. The absence of association with 25(OH)D, PTH, and bone turnover markers may be due to the fact that TBS assesses a specific (mostly trabecular) part of the skeleton, whilst the three serum factors are related to the whole skeleton.

Impact of Rheumatoid Arthritis and Its Management on Falls, Fracture and Bone Mineral Density in UK Biobank.

Objectives: Rheumatoid arthritis (RA) is a systemic chronic inflammatory disease which presents with polyarthritis in addition to extra-articular manifestations. Historically, studies have shown a link between RA and adverse musculoskeletal outcomes but these studies were reported before the widespread use of biologic therapies. The aim of this study was therefore to investigate associations between RA, RA medications and bone mineral density, falls and fractures, using UK Biobank data.Methods: Diagnosis of RA was made using Hospital Episode Statistics (HES) ICD-10 coding. We assessed RA relationships with estimated bone mineral density (eBMD) from heel quantitative ultrasound measurements, self-reported falls (in last year) and HES recorded fracture, adjusted for age, ethnicity, BMI, smoking status, and physical activity.Results: Of 502,543 participants, 3849 (1.4%) of women and 1643 (0.7%) of men had a diagnosis of RA. Median age of the participants was 57 years (IQR 50–63) in women and 58 (IQR 50–64) in men. RA was associated with lower eBMD (men: β −0.244, 95% CI −0.378, −0.110 p < 0.001; women: β −0.217, 95% CI −0.297, −0.138 p < 0.001) a reported fall in the last year (men: OR 1.54, 95% CI 1.26, 1.87 p < 0.001; women: OR 1.36, 95% CI 1.19, 1.56 p < 0.001) and fracture in women (OR 1.76, 95% CI 1.43, 2.16 p < 0.001). Corticosteroid therapy in men (β −0.934, 95% CI −1.565, −0.304 p = 0.004) and disease modifying anti-rheumatic drug (DMARD) use in both sexes (men: β −0.437, 95% CI −0.761, −0.112 p = 0.008; women: β −0.243, 95% CI −0.421, −0.065 p = 0.007), but not biologic therapy, were associated with a lower eBMD with RA.Conclusions: RA was associated with lower eBMD, increased falls and fracture. Corticosteroid and DMARD therapy, but not biologic therapy, were associated with lower eBMD.

Skeletal status assessed by quantitative ultrasound and dual-energy X-ray absorptiometry in children with inflammatory bowel disease: A 2-year prospective study

To assess the bone status in children with inflammatory bowel diseases (IBD) using quantitative ultrasound (QUS) measurement and dual-energy X-ray absorptiometry (DXA) at baseline and after two years of adequate treatment of the IBD and bone protection medication. Sixteen children (six boys) with IBD, aged 13.4±2.4 years, were examined at baseline and two years later. DXA was used to asses bone mineral density (BMD) and reference data were provided by the device's manufacturer (Hologic Explorer). QUS measurements were performed in patients and controls-48 healthy children. Mean Z-scores for TB- and s-BMD were significantly below zero for both, baseline and follow-up (-2.61±0.99 and -2.48±0.88 for TB, and -1.83±1.33 and -1.61±1.19 for s-BMD, respectively), and did not differ significantly, as well as mean Ad-SoS Z-score. The changes in time of TB Z-score and body weight Z-score correlated positively (r=0.63; P<0.01). The QUS results did not differ between patients and controls. There was a negative correlation between the baseline nutritional status and the activity of the disease, as well as of the number of flares before the enrolment and Ad-SoS Z-score. BMD was found to be lowered both at baseline and follow-up. No further deterioration was observed during 2-year follow-up. Proper treatment, defined as treatment following ECCO Guidelines, may allow to keep a similar trend in the development of bone tissue as in healthy children. The bone properties assessed by QUS method did not differ between patients and controls. QUS at hand phalanges appears not to be proper diagnostic tool in IBD children.

Growth patterns, metabolic indicators and osteoarticular status in the Lusitano horse: A longitudinal study.

Development of a healthy musculoskeletal system is of high concern for horse breeders and users. A longitudinal field study was performed in order to: (i) evaluate growth patterns and long-term changes on bone quality, bone metabolism, growth factors and metabolic variables in the Lusitano horse; and (ii) retrospectively assess whether these changes were related with radiographic findings regarding osteochondrosis-like lesions (OC) at the onset of training. Thirty-four Lusitano foals born and raised at four stud-farms, were periodically weighed (BW), and measured (withers height-WH) from birth to 36 months of age. On the same days, blood samples were collected for determination of osteocalcin, bone alkaline phosphatase, insulin-like growth factor I (IGF-I), leptin, insulin, glucose, parathyroid hormone (PTH), calcium, phosphorus and magnesium plasma concentrations, and quantitative ultrasound measurements were performed on the right third metacarpal bone (McIII). At the end of the study horses underwent radiographic examination of the four fetlocks, hocks and stifles. According to their radiographic status (OC negative vs. OC positive), Richards growth function was adjusted to BW and WH data. Instantaneous BW and WH growth rates (BW IADG and WH IADG) were calculated for each foal, from the resolution of the first derivative of growth models for seven age-classes. The presence of radiographic findings compatible with OC at the onset of training was associated with changes in BW and WH growth rates. Positive horses presented higher BW IADG from six to 18 months of age and lower WH IADG before 45 days of age (P<0.001). Speed of sound measurements (SOS), bone markers, growth factors and other metabolic variables change markedly with age (P<0.01). OC positive horses tended to have lower SOS values at the lateral region of McIII, lower IGF-I, and higher insulin and PTH concentrations (P<0.1). This study provides indirect evidence that monitoring foals’ growth during the first year of life may be of assistance in managing the occurrence of OC. Further studies with a higher number of animals and a controlled feed intake should be pursued.

Muscle Strength and Bone Strength Assessed with Osteo-sono Assessment Index Among Recreationally Athletic Japanese Women

Low muscle strength is an independent risk factor for low bone strength, which is a well-established predictor of osteoporotic fracture. However, the association between muscle strength and bone strength remains unclear among recreationally athletic Asian women. PURPOSE: To investigate the association between muscle strength and bone strength among recreationally athletic Japanese women. METHODS: This cross-sectional study was conducted in 7091 recreationally athletic Japanese women [mean (standard deviation), age 50.3 (15.2) years] who had undergone medical checkup and various exercise tests voluntarily from 1998 to 2016 at a preventive medical center. Participants completed a maximal voluntary knee extension test, quantitative ultrasound (QUS), calcaneal measurements, a medical examination, and questionnaires on lifestyle. Muscle strength, expressed as Nm per body weight in kilogram (Nm/kg), was measured at 60 degrees/s in the knee with an isokinetic dynamometer. The osteo-sono assessment index (OSI) evaluated right calcaneus heel bone strength using a QUS measurement. Multiple linear regression analysis assessed independent association of muscle strength and OSI (×106) after adjustment for age, systolic blood pressure, smoking, drinking, prevalence of diabetes, and body mass index. RESULTS: Muscle strength had a positive association with OSI score after adjustment for potential confounding factors (β=0.17, 95% confidence interval; 0.15-0.19, p <0.001). Furthermore, age-stratified (≥50 years and under) analyses showed similar patterns of association. CONCLUSIONS: Our results suggest a dose-response association between muscle strength and bone strength after adjustment for potential confounding factors. We need to further investigate longitudinal relationship between muscle strength and bone strength in a cohort study.

P246 Evaluation of the nursing state with dual energy x-ray absorptiometry and calcaneus quantitative ultrasound measurements in children with cystic fibrosis

P246 Evaluation of the nursing state with dual energy x-ray absorptiometry and calcaneus quantitative ultrasound measurements in children with cystic fibrosis

Determinants of bone mineral density through quantitative ultrasound screening of healthy children visiting ambulatory paediatric clinics.

Objectives:To investigate the determinants of bone mineral density through screening healthy children using a non-invasive quantitative ultrasound measurement device.Methods:A descriptive cross-sectional study carried out at King AbdulAziz University Hospital, Jeddah, Kingdom of Saudi Arabia. between May 2018 and January 2019 through interviewing, examining, and screening healthy children visiting general paediatric. Total sample size encompassed 450 children. The inclusion criteria were healthy children between the ages of 2 and 20 years. Exclusion criteria were previous pathological fractures, chronic medical diseases, or long-term medications. Data entry and analysis was conducted using Statistical Package for Social Sciences version 24 (IBM Corp, Armonk, NY, USA). Chi-square tests were used to determine the association between categorical variables, with calculated p<0.05 considered significant. With one-way Anova testing to study the relationship between categorical variables and continuous variables.Results:A significant association with bone mineral density (BMD) was found during first 2 years with height (p=0.015), vitamin D supplementation (p=0.03), and breastfeeding (p=0.025). A directly proportional relationship with BMD was found with pubertal status, physical activity, diet, sun exposure, and calcium supplement intake.Conclusion:This is a novel study in the investigation of the dietary, lifestyle and demographic determinants of bone mineral density in the healthy middle-eastern child otherwise unaffected by chronic medical or metabolic disease or exposed to long term medications that could have affected bone metabolism.

Trabecular bone score and quantitative ultrasound measurements in the assessment of bone health in breast cancer survivors assuming aromatase inhibitors.

Aromatase inhibitors (AIs) represent the first-line adjuvant therapy for hormone receptor-positive breast cancer (BC) women. AIs have been associated with an increased rate of fractures. The aim of our study was to investigate trabecular bone score (TBS) and bone quantitative ultrasound (QUS) measurements as bone quality surrogates in AIs users. Sixty postmenopausal BC women starting AIs and forty-two controls (mean age 61.64 ± 8.33years) were considered. Bone mineral density (BMD) at lumbar spine and femoral neck and TBS were measured by DXA; QUS-derived Amplitude-Dependent Speed of Sound (AD-SoS), Bone Transmission Time (BTT), and Ultrasound Bone Profile Index (UBPI) were assessed at phalangeal site; morphometric vertebral fractures (Vfx) by X-ray, serum bone-specific alkaline phosphatase (BSAP), and C-telopeptide of type 1 collagen (CTX) were also evaluated. After 18months, changes of TBS vs baseline were significantly different between AIs group and controls [Δ TBS - 2.2% vs - 0.4%, respectively, p = 0.001]. AD-SoS, BTT and UBPI values decreased only in AIs' group (- 3.7%, - 6.45%, -8.5%, vs baseline, respectively, pall < 0.001). 3 Vfx occurred in AIs users and were associated with the greater TBS and AD-SoS modifications. In the AIs' group, ΔTBS was associated with ΔAD-SoS (r = 0.58, p < 0.001) and ΔUBPI (r = 0.415, p = 0.001), but not with ΔBMD. Moreover, ΔTBS was independently predicted by ΔAD-SoS, after correcting for BMD, CTX and BSAP level changes (β = 0.37, SE = 2.44, p < 0.001). TBS and phalangeal QUS provide useful information related to bone quality in AI-treated BC survivors and could be considered for fracture risk evaluation.

Is waist circumference a negative predictor of calcaneal bone mineral density in adult Chinese men with normal weight?

Our study aimed to evaluate the association between waist circumference (WC) and calcaneal bone mineral density (BMD) in adult Chinese men with normal weight. This was a cross-sectional study. A total of 4,663 male participants aged 40 years or older residing in Ningde and Wuyishan, two cities locating in Fujian province of China, were randomly recruited between 2011 and 2012. Each participant should complete a standard questionnaire, undergo anthropometric and calcaneus quantitative ultrasound (QUS) measurements and have blood sample taken. Anthropometric, biochemical and calcaneal QUS parameters of 1,583 male participants with BMI ranging from 18.5 to 22.9 were included in the analysis. WC was divided into quartiles (Q1-Q4: <71, 71-75, 75-78, >78 cm). The relationship between WC (quartiles) and BMD was analyzed by multiple linear regression models. Mean age of the whole population was 54.6±9.8 years. Anthropometric and biochemical parameters were almost normal. Multiple linear regression analysis showed that BMD was negatively associated with increasing WC quartiles except for Q2 after adjusting for age and BMI, and this relationship remained negative except for Q2 when further adjustment was made for other covariates. Multiple logistic regression model also showed that the risks of osteopenia and osteoporosis increased across WC quartiles. The present study indicated that WC was a negative predictor of calcaneal BMD in adult Chinese men with normal weight. It suggests that, even for the normal-weight Asian males, monitoring accrual of abdominal adipose is still helpful for the purpose of preventing bone loss.