Agreement Between Dual-Energy X-Ray Absorptiometry and Quantitative Ultrasound to Evaluate Bone Health in Adolescents: The PRO-BONE Study

Purpose: The present study aims to investigate the association between dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters and the intermethods agreement in active males. Methods: In this cross-sectional study, bone health (by DXA and calcaneal QUS), physical activity (by accelerometers), and anthropometrics measurements were assessed in 117 active adolescents (12-14 y old). Bivariate correlation coefficients were calculated to assess the relationships between DXA standard regions of interest and QUS parameters. Intraclass correlation coefficients and Bland-Altman plots were used to assess the level of agreement between bone mineral content regions derived from DXA and stiffness index. The measurements were z score transformed for comparison. Results: Most QUS parameters were positive and significantly correlated with DXA outcomes (stiffness index: r = .43-.52; broadband ultrasound attenuation: r = .50-.58; speed of sound: r = .25-.27) with the hip showing the highest correlations. Moreover, the present study found fair to good intraclass correlation coefficients of agreement (.60-.68) between DXA and QUS to assess bone health. The Bland-Altman analysis showed a limited percentage of outliers (3.2%-8.6%). Conclusion: QUS device could represent an acceptable alternative method to assess bone health in active adolescent males.