Fulltext

Combining bone resorption markers and heel quantitative ultrasound to discriminate between fracture cases and controls

Nanchen, D. ; Cornuz, J. ; Ruffieux, C. ; Riesen, W. ; Burckhardt, P. ; Krieg, M.

In: Osteoporosis International, 2009, vol. 20, no. 10, p. 1695-1703

Add to personal list
    Title
    • Combining bone resorption markers and heel quantitative ultrasound to discriminate between fracture cases and controls
    Author
    • Nanchen, D.. Department of Ambulatory Care and Community Medicine, University of Lausanne, 44 Rue du Bugnon, 1011, Lausanne, Switzerland
    • Cornuz, J.. Department of Ambulatory Care and Community Medicine, University of Lausanne, 44 Rue du Bugnon, 1011, Lausanne, Switzerland
    • Ruffieux, C.. Institute of Social and Preventive Medicine, University of Lausanne, 17 Rue du Bugnon, 1005, Lausanne, Switzerland
    • Riesen, W.. Institute of Clinical Chemistry and Hematology, State Hospital of St.Gall, Haus 20, 9007, St. Gall, Switzerland
    • Burckhardt, P.. Bois-Cerf Clinic, Avenue d'Ouchy 31, 1006, Lausanne, Switzerland
    • Krieg, M.. Department of Ambulatory Care and Community Medicine, University of Lausanne, 44 Rue du Bugnon, 1011, Lausanne, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:318908
    Summary
    Summary: This nested case-control analysis of a Swiss ambulatory cohort of elderly women assessed the discriminatory power of urinary markers of bone resorption and heel quantitative ultrasound for non-vertebral fractures. The tests all discriminated between cases and controls, but combining the two strategies yielded no additional relevant information. Introduction: Data are limited regarding the combination of bone resorption markers and heel quantitative bone ultrasound (QUS) in the detection of women at risk for fracture. Methods: In a nested case-control analysis, we studied 368 women (mean age 76.2 ± 3.2years), 195 with low-trauma non-vertebral fractures and 173 without, matched for age, BMI, medical center, and follow-up duration, from a prospective study designed to predict fractures. Urinary total pyridinolines (PYD) and deoxypyridinolines (DPD) were measured by high performance liquid chromatography. All women underwent bone evaluations using Achilles+ and Sahara heel QUS. Results: Areas under the receiver operating-characteristic curve (AUC) for discriminative models of the fracture group, with 95% confidence intervals, were 0.62 (0.56-0.68) and 0.59 (0.53-0.65) for PYD and DPD, and 0.64 (0.58-0.69) and 0.65 (0.59-0.71) for Achilles+ and Sahara QUS, respectively. The combination of resorption markers and QUS added no significant discriminatory information to either measurement alone with an AUC of 0.66 (0.60-0.71) for Achilles+ with PYD and 0.68 (0.62-0.73) for Sahara with PYD. Conclusions: Urinary bone resorption markers and QUS are equally discriminatory between non-vertebral fracture patients and controls. However, the combination of bone resorption markers and QUS is not better than either test used alone