Three-Year Prospective Study on Fracture Risk in Postmenopausal Women by Quantitative Ultrasound at the Phalanges

The purpose of this study was the calculation of fracture risk in a prospective study on postmenopausal women by quantitative ultrasound (QUS) at the phalanges. A total of 2341 postmenopausal women were recruited in 5 centers in Italy during 2006 and 2007 for QUS measurement during a screening program for osteoporosis. Two ultrasound parameters were collected: amplitude-dependent speed of sound (AD-SoS) and ultrasound bone profile index (UBPI). Women were then recontacted in 2010 and were asked about fracture occurrence during the period since previous QUS measurement. Data about new fracture occurred in this period, site and cause of fracture were requested. Two thousand two hundred eleven women were successfully recontacted. Mean age of the recruited women was 60.9 +/- 10.0 yr, mean age at menopause was 49.3 +/- 4.4 yr, mean body mass index (BMI) was 26.5 +/- 4.6 kg/m(2). A total number of 108 new major osteoporotic fractures occurred during the 3-yr period, of which 23 are hip fractures, 51 are vertebral fractures. Relative risk (RR) per standard deviation (SD) decrease for major fractures was 1.77 (confidence interval [CI]: 1.59-1.97) for AD-SoS and 2.06 (CI: 1.78-2.37) for UBPI. When corrected for age, BMI, age at menopause, the RRs are still significant and equal to 1.44 (CI: 1.26-1.65) for AD-SoS and 1.67 (CI: 1.39-2.00) for UBPI. RR for vertebral fractures was 1.63 (CI: 1.41-1.88) for AD-SoS and 1.73 (CI: 1.44-2.08) for UBPI. RR for hip fractures was 1.92 (CI: 1.55-2.37) for AD-SoS and 2.68 (CI: 1.86-3.86) for UBPI. Ultrasound parameters AD-SoS and UBPI are able to significantly predict future major fractures in a prospective cohort of more than 2000 postmenopausal women.