Comparative analysis of bone mineral density results using dual energy x-ray absorptiometry of spine and ultrasound densitometry of calcaneus in lithuanian

Objectives. To determine and compare the accuracy of testing bone mineral density (BMD) using ultrasound densitometry of calcaneus (US) and dual-energy X-ray absorptiometry of lumbar spine (DXA) in women of different age groups. Methods. BMD was tested in 9979 women in the region of Kaunas, Lithuania. DXA method of spine was used to determine MD in 6976 women aged 35-96, also 3003 women aged 35-92 were tested using US of calcaneus. Each subject was classified by DXA or US using the WHO criteria as normal, osteopenic or osteoporotic, defined at lumbar spine or calcaneus. The BMD results, diagnosed using US and DXA densitometries, were analyzed by 5-year age groups. Results. The inverse correlation between the age and T score data was determined (DXA r=-0.36 and US r=-0.44). Normal BMD values dominate in women aged 35-49 by DXA of the lumbar spine and in age group 35-54 by US of calcaneus. T score values characteristic to osteopenia dominate while testing women 50-59 years old by DXA, but 55-59 while testing by US. T score values characteristic to OP dominate while testing women 60-79 years old by DXA but osteopenia while testing by US. T score values characteristic to OP dominate in age group does not satisfy 80 while testing by both - DXA and US - methods. OP makes 52.2% in age group > 65 while tested by DXA and 41.7% by US (p < 0.01, r=0.02). Conclusions. Calcaneal US is not a substitute for DXA measurement of the lumbar spine. US screening for OP may be suitable for the "younger" perimenopausal women. Peripheral US cannot be considered equivalent surrogate for central DXA in the screening of postmenopausal women for OP. Improvement in OP prevention and screening, in primary care is needed.