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Low bone status on calcaneal quantitative ultrasound among community screening attendees in rural northern Vietnam: a
Phuong Thuy Pham1,2, Thuy Minh Ha3, Huy Quoc Nguyen1
1Vietnam University of Traditional Medicine, Hanoi, Viet Nam.
Objective:
To estimate the proportion with low bone status among adults aged 50 years and older attending a community bone health screening programme in rural northern Vietnam, using calcaneal quantitative ultrasound (QUS), and to examine associated factors.
Design:
Community-based cross-sectional study.
Setting:
Kieu Phu, a rural commune of Hanoi, Vietnam (population approximately 60 900), where a one-off community bone health screening programme was conducted between October and December 2025.
Participants:
A total of 592 community-dwelling adults aged 50 years and older attending the screening programme.
Primary And Secondary Outcome Measures:
The primary outcome was low bone status, operationally defined as a QUS T-score ≤-2.5. Crude and adjusted ORs were estimated using logistic regression.
Results:
The mean age of participants was 74.8 years (SD 7.7) and 58.4% were women. Overall, 355 of 592 participants had low bone status on calcaneal QUS (60.0%, 95% CI 56.0% to 63.8%). In the adjusted model, female sex showed the strongest association with low bone status (adjusted OR 8.71, 95% CI 5.77 to 13.15), and underweight participants had higher odds than those with a body mass index of 18.5-22.9 kg/m² (adjusted OR 2.11, 95% CI 1.15 to 3.87). Age ≥70 years, education level, former occupation, main income source, high sodium intake, hypertension and diabetes mellitus were not independently associated with low bone status.
Conclusions:
Low bone status on calcaneal QUS was common among attendees of a rural community screening programme in northern Vietnam and was independently associated with female sex and underweight status. Because participants were screening attendees rather than a probability sample, these findings are not prevalence estimates for the wider rural population. Calcaneal QUS is not equivalent to dual-energy X-ray absorptiometry (DXA)-based diagnosis but may support early risk identification where DXA access is limited, provided screening is linked to accessible confirmatory assessment and referral.
