Using quantitative ultrasound for epidemiological research : associations with risk factors for low bone mineral density in South African premenopausal women

Master Thesis

2008

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University of Cape Town

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Quantitative Ultrasound (QUS) measurement at the calcaneum is a convenient, cost effective and noninvasive method of determining bone strength well suited to community-based research in countries with limited resources. Although only moderately correlated with dual X-ray absorptiometry (DEXA) measurement of bone mineral density (BMD) at the hip and spine, quantitative ultrasound has shown to be a reliable predictor of osteoporotic fracture. This study aims to evaluate the use of QUS in epidemiological studies in South African settings. To this end, this report determines whether characteristics associated with QUS measures of bone strength in a large sample of premenopausal South African women are similar to those known to be associated with the BMD as measured by DEXA, and compares these associations with those in other populations. This cross-sectional study included 3493 black and mixed race women aged 18 - 44 living in Cape Town. Trained study nurses administered structured interviews on reproductive history and lifestyle factors. In addition they took height, weight and calcaneal QUS measurements using the Sahara device. Adjusted means of QUS measures according to categories of risk factors were obtained using multivariable regression analysis. In both groups associations between QUS measures and age, Body Mass Index (BMI), age at menarche, parity and primary school physical activity were similar to those known to be associated with BMD as measured by DEXA. There were no clear associations between QUS and educational level, alcohol use, cigarette smoking, and current calcium intake. The data give support to the use of QUS as an epidemiological tool in large studies of bone strength in premenopausal women.
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Includes bibliographical references (leaves 57-63).

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