Identification of patients with a high risk of osteoporosis. Analysis of risk factors, ultrasonography and DEXA, in a female population in the North East of Italy.

ABSTRACT

AIM: The aim of this observational study is the identification of women at high risk of osteoporosis by using the phalangeal quantitative ultrasound (QUS) value for osteoporosis screening. METHODS: The study population is composed of 1 152 women between 35 and 79 years old, both premenopausal and postmenopausal. Each woman underwent a questionnaire and phalangeal QUS. One hundred and forty-eight women also underwent dual energy X-ray absorptiometry (DEXA). Osteopenia and osteoporosis, as determined using the amplitude dependent speed of sound (AD-SoS) T-score, identified women at a high risk of fracture. Data were stored and analyzed using SPSS (Statistical Package for Social Science) for Windows. RESULTS: AD-SoS is significantly higher in premenopausal women than in postmenopausal women without history of hormone replacement therapy (HRT) (P<0.001), if they are over 50 years old. In women 50-59 years old, AD-SoS is significantly higher in premenopausal women than in postmenopausal women with or without HRT history (P<0.001). In postmenopausal women, discriminant analysis found that HRT and years of HRT are the only significant protective factors (P<0.001). In premenopausal and postmenopausal women with no history of HRT use, discriminant analysis demonstrated that early menopause and a family history of osteoporosis are the only significant risk factors (P<0.001). CONCLUSION: Early menopause and a family history of osteoporosis seem to be the greatest risk factors, while HRT seems to be a protective factor. The QUS technique, with DEXA as a secondary test, can be a screening test for the identification of postmenopausal women with a high risk of fracture.