E-Tracking Technique In Assessment Of Common Carotid Elasticity In Postmenopausal Women With Osteoporosis

Objective: To investigate the application value of E-Tracking(ET)technique in assessment of common carotid arterial elasticity in postmenopausal women with osteoporosis(OP).Methods: Fifty-two patients diagnosed with osteoporosis by dual-energy X-ray absorptiometry(DXA)(OP group)and fifty normal cases(control group),who are all postmenopausal Han Chinese within one to ten years after menopause,were chosen respectively from patients of Osteoporosis Department and healthy checkup population of Affiliated Zhongshan Hospital Dalian University.The main parameters are measured as follows: 1.The T value of bone mineral densities of orthophoric 1-4 lumber vertebrae.2.The intima-media thickness(IMT)of the right common carotid artery were measured by routine ultrasound.3.The elasticity parameters of the right common carotid artery including pressure-strain elasticity modulus(Ep),stiffness parameter(β),compliance(AC),augmentation index(AI),pulse wave velocity(PWVβ)were measured by ET technique.4.The sex hormones including estradiol(E2)and follicle stimulating hormone(FSH)were measured.5.The blood fat parameters including total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C)and high density lipoprotein(HDL-C)were measured.These parameters of OP group were compared with them of control group.In addition,the partial correlation of OP group between T-score and the elasticity parameters β,AI,AC,PWVβ and Ep was analyzed,as well as the correlation between E2 and T-score for bone mineral density,the elasticity parameters Ep,β,AC,AI and PWVβ.Then the receiver operating characteristic(ROC)curve of the elasticity parameters Ep,β,AC and PWVβ was drawn and analyzed.Thearea under the curve(AUC),critical value,sensitivity and specificity were calculated.Result: 1.Comparison of general data: there is no significant difference in age,menopause age,systolic and diastolic blood pressure,body mass index(BMI)(P>0.05)between two groups.The T-score for bone mineral density of OP group is lower than it of control group.Meanwhile,the difference of T-score between both groups is statistically significant(P<0.01).There is significant difference in E2(P<0.05)between both groups.There is no statistical significant difference in FSH between both groups.There is no statistical significant difference in TC,TG,LDL-C and HDL-C(P>0.05)between both groups..2.The intima-media thickness(IMT)of common carotid artery by routine ultrasound has no statistical significance(P>0.05).3.The elasticity parameters of common carotid artery by ET technique: the parameters β,PWVβ and Ep of OP group is higher than them of control group with statistical significance(P<0.01).The parameter AC of OP group is lower than it of control group with statistical significance(P<0.05).However,the parameter AI between OP group and control group is not statistically significant(P>0.05).4.The correlation analysis: it is negative correlation between T-score for bone mineral density and β(r=-0.513,P= 0.000),Ep(r=-0.500,P=0.000),PWV(r=-0.655,P=0.000)after controlling for age and E2.However,T-score is positively related to AC(r=0.270,P=0.014).There is no association between T-score and AI(r=-0.178,P=0.690).It is negative correlation between E2 and PWVβ(r=-0.354,P=0.01)and β(r=-0.365,P= 0.008).There is no association between E2 and Ep(r=-0.231,P=0.100),AC(r=0.073,P=0.605),AI(r=-0.001,P=0.992).5.ROC curve analyses: the areas under ROC curve of elasticity parameters Ep,β,AC and PWVβ is equal to 0.772,0.757,0.635 and 0.870,respectively.When the sum of sensitivity and specificity is equal to maximized,the critical value of Ep,β,AC and PWVβ is equal to 112.5(The sensitivity is 84.5%,the specificity is 62.0%.),9.5(The sensitivity is 73.1%,the specificity is 72.0%.),0.765(The sensitivity is 54.0%,the specificity is 76.9%.)and 7.08(The sensitivity is 84.6%,the specificity is 82.0%.),respectively.Conclusion:The elasticity function of common carotid artery of postmenopausal women with OP is decreased.OP is correlative with elasticity function of common carotid artery.The ET technique can early and quantificationally evaluate the elastic function of common carotid artery in postmenopausal OP patients.Moreover,the sensitivity and specificity of PWVβ measured by ET technique are good.It is expectedto be a valuable indicator for ultrasound to evaluate the carotid elastic function in postmenopausal OP patients.