Ultrasound measurements of proximal phalanges in Polish early postmenopausal women.

The aim of this cross-sectional study was to evaluate skeletal status in Polish early postmenopausal women using ultrasound measurement at the proximal phalanges of the hand. We assessed the ability of the method to discriminate between healthy and osteoporotic individuals, the influence of age and menopause on ultrasound values, the impact of hormone replacement therapy and the relationships between ultrasound measurement and type of fracture. Five hundred and three early postmenopausal women were divided into three groups: (1) healthy (n = 398, mean age 53.4 years), (2) fractured (n = 43, mean age 53.9 years), (3) treated with estrogens (n = 62, mean age 53.5 years). Groups were matched for age and years since menopause (YSM). Group 2 was subdivided into those with and without wrist fracture. No drugs except estrogens were used by the subjects studied and no diseases known to affect bone metabolism were observed. Bone status was assessed by a DBM Sonic 1200 (Igea, Italy), a device that measures amplitude-dependent speed of sound (AD-SoS) at the proximal phalanges II-V of the hand. AD-SoS had the highest value in estrogen-treated women (1996.5 +/- 66.5 m/s), the lowest in fractured persons (1883.6 +/- 77.1 m/s) and a medium value in healthy women (1949.2 +/- 78.0 m/s). All values were significantly different from each other (p < 0.0001). AD-SoS values for the subgroups of group 2 were 1873.0 +/- 80.6 m/s for those with wrist fracture and 1914.0 +/- 73.0 m/s for those without; they were not statistically different. The hypothesis that AD-SoS at the proximal phalanges might be more sensitive to wrist fracture was not confirmed by Fisher's exact test for frequencies. Linear regression showed age-related changes, with r values -0.4 (p < 0.00001), -0.47 (p < 0.005), -0.37 (p < 0.005), and YSM-related changes, with r values of -0.44 (p < 0.00001), -0.32 (p < 0.005), and -0.18 (NS) in groups 1, 2 and 3, respectively. It is concluded that: (1) ultrasound measurements of the proximal phalanges were able to discriminate between healthy and osteoporotic individuals; (2) the method is useful in detecting age and postmenopause-related changes within the skeleton; and (3) hormone replacement therapy significantly reduced the impact of the menopause on bone loss as detected by ultrasound.