ABSTRACT
Introduction: The objective of this study was to establish the broadband ultrasound attenuation (BUA) measurements of the calcaneum for Southeast Asian males and females. A database was used to draw the reference curve for the Southeast Asian male and female population. Materials and Methods: The database included 366 healthy females and 236 healthy males. We measured the BUA values of the left heel using the Contact Ultrasound Bone Analyser (CUBA) clinical system. Results: The mean difference between Southeast Asian males and Caucasian males was 9.3 dB MHz-1and that for females was 5.0 dB MHz -1. The standard deviations (SDs) for Southeast Asian female and male normative values were 17.43 and 20.10, respectively. This is comparable with the SD for the McCue Caucasian female and male normative data of 16.54 and 17.45 respectively. Conclusion: The study shows that the Southeast Asian population has a significantly lower normative value than the Caucasian population. This BUA reference data-base obtained will allow for more accurate determination of Southeast Asian patients at risk of osteoporosis.
Quantitative ultrasound (QUS) systems measuring the calcaneus are currently approved for the assessment of osteoporotic risks in Europe, Canada and the USA. A QUS bone sonometer basically measures, in ms–1 , how quickly sound travels through the bone, i.e., the velocity of sound (VOS) and, in dB MHz-1, how much sound is absorbed by the bone, i.e., broadband ultrasound attenuation (BUA). An osteoporotic bone absorbs less ultrasound compared to a denser bone with a different microstructure. Hence, measurement by QUS is an evaluation of bone status relating to its density as well as microstructure. Unlike QUS, bone mineral density (BMD) tests measure only density. Cancellous bone is 8 times more metabolically active than cortical bone. Age and disease related to bone loss is more readily apparent at sites where there is a high percentage of cancellous bone i.e., the hip. Calcaneum is a bone that is 75% to 90% cancellous, similar to the hip. There is little soft tissue surrounding the bone, making it an excellent site for BUA measurement. It has also been established that BUA is a more significant predictor of fracture risks compared to VOS.
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