Low bone status on calcaneal quantitative ultrasound among community screening attendees in rural northern Vietnam: a cross-sectional study
Phuong Thuy Pham, Thuy Minh Ha, Huy Quoc Nguyen, Binh Quoc Pham, Cuong Manh Le, Anh Hoang Bui, Lam Vu Trinh, Trang Thi Thu Pham, Mien Thi Pham, Khiem Van NguyenObjective
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.