Endocrine Abstracts

Introduction: The heel quantitative ultrasound (QUS) is useful tool in the assessment of fracture risk especially if cost issues are involved. It might be helpful in follow-up the patients who will not be treated with anti-osteoporotic drugs.

Aim: To present the bone evaluation (DXA) after a period of time in patients who are initially assesed by both DXA and QUS.

Material and patients: This is a prospective pilot study in a group of postmenopausal women. They were not treated with anti-resorbtive drugs at first evaluation, meaning central DXA (at least two sites) and heel QUS (GE Achilles). After at least one year they were re-evaluated only by DXA (because of data lack in QUS use in patients treated with anti-osteoporotics as the patients initially diagnosed with osteoporosis started therapy).

Results: Out of 360 patients who were first evaluated, 61 patients were followed-up for mean 23.53 months. The initial mean age was 55.77 years. We formed two sub-groups of patients based in QUS stiffness index (SI). Lower SI than 79 U (meaning high fragility fracture risk) includes a group of 29 patients (mean SI of 95.61 U, and higher SI than 79 U (meaning low fracture risk) includes 32 patients (control group) with a mean SI of 61.9 U. The number/percent of patients in each group with osteoporosis/osteopenia/normal DXA were in studied group: 5 patients/17.24%, 16 patients/55.17%, 8 patients/27.58%; in control group 7 patients/21.8%, 10 patients/31.25, and 15 patients/46.87%. The patients were followed-up for 23.78 months in group 1 vs 22.81 months in group 2. The second DXA evaluation showed in the first group 20.68% of patients had significant changes in bone mineral sensity (16.66% of these had higher BMD and the others lower BMD), while only 9.3% of women from the control group had significant changes in BMD (all higher BMD).

Conclusion: In patients with high fragility fracture risk based on QUS, the ~2 years follow-up period of time pointed a higher number of patients with significantly BMD decreased than the group with low fracture risk. This is an argument that the DXA and QUS are two complementary methods in fracture risk evaluation.