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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:337-343 • 0278-4297

Quantitative Heel Ultrasonography, 25-Hydroxyvitamin D, and Urine Amino-terminal Cross-linking Telopeptide of Type I Collagen in Patients With a Recent Hip Fracture

Edward Colt, MD, George Gorich, MD, Stephen Quinnan, MD, Ramona Raj, MD, John Thornton, PhD, Brenda Matti, MD, Richard Pierson, Jr, MD and Eileen Quinlan, NP

St Luke’s Roosevelt Hospital and Columbia University, New York, New York USA.

Address correspondence to Edward Colt, MD, University Medical Practice Associates, 1090 Amsterdam Ave, New York, NY, 10025 USA. E-mail: ecolt{at}chpnet.org

Objective. This study examined quantitative heel ultrasonography (QUS), 25-hydroxyvitamin D (25-OHD) levels, and urine amino-terminal cross-linking telopeptide of type I collagen (NTX-I) levels in patients with a recent osteoporotic hip fracture to see whether they were clinically useful. Methods. Stiffness index (SI) T scores from QUS, 25-OHD levels, and urine NTX-I levels were obtained in 53 female and 32 male patients with hip fractures. Sixty-five female patients and 5 male patients attending our geriatric clinic were used for comparison. Results. The SI T scores of the hip fracture patients were less than those of the geriatric clinic patients. The difference was significant in female patients (P = .0001) but not in male patients (P = .1). Serum levels of 25-OHD were less than 28 ng/mL in 50 of 59 patients and less than 5 ng/mL in 2 patients. Levels of urine NTX-I were variable and were not correlated with other parameters. Conclusions. Patients who have had a hip fracture have a low SI determined by QUS; this is easy to perform, and it provides a baseline T score from which to assess treatment effects. Most of these patients are vitamin D deficient, and measurement of the 25-OHD level would enable physicians to prescribe an appropriate dose of vitamin D. Urine NTX-I measured shortly after a hip fracture is not clinically helpful.

Key Words: age • amino-terminal cross-linking telopeptide of type I collagen • body mass index • heel ultrasonography • hip fracture • 25-hydroxyvitamin D

Abbreviations: BCE, bone collagen equivalent • BMD, bone mineral density • BMI, body mass index • BUA, broadband ultrasound attenuation • Cr, creatinine • DXA, dual-energy x-ray absorptiometry • NTX-I, amino-terminal cross-linking telopeptide of type I collagen • QUS, quantitative heel ultrasonography • SI, stiffness index • 25-OHD, 25-hydroxyvitamin D

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.