Normative calcaneal quantitative ultrasound data for the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon

Felicia C. Madimenos, J. Josh Snodgrass, Aaron D. Blackwell, Melissa A. Liebert, Tara J. Cepon, Lawrence S. Sugiyama

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Summary Minimal data on bone mineral density changes are available from populations in developing countries. Using calcaneal quantitative ultrasound (QUS) techniques, the current study contributes to remedying this gap in the literature by establishing a normative data set on the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon. Purpose The paucity of bone mineral density (BMD) data from populations in developing countries partially reflects the lack of diagnostic resources in these areas. Portable QUS techniques now enable researchers to collect bone health data in remote field-based settings and to contribute normative data from developing regions. The main objective of this study is to establish normative QUS data for two Ecuadorian Amazonian populations-the indigenous Shuar and non-Shuar Colonos. The effects of ethnic group, sex, age, and body size on QUS parameters are also considered. Methods A study cohort consisting of 227 Shuar and 261 Colonos (15-91 years old) were recruited from several small rural Ecuadorian communities in the Upano River Valley. Calcaneal QUS parameters were collected on the right heel of each participant using a Sahara bone sonometer. Three ultrasound generated parameters were employed: broadband ultrasound attenuation (BUA), speed of sound (SOS), and calculated heel BMD (hBMD). Results In both populations and sexes, all QUS values were progressively lower with advancing age. Shuar have significantly higher QUS values than Colonos, with most pronounced differences found between pre-menopausal Shuar and Colono females. Multiple regression analyses show that age is a key predictor of QUS while weight alone is a less consistent determinant. Both Shuar males and females display comparatively greater QUS parameters than other reference populations. Conclusions These normative data for three calcaneal QUS parameters will be useful for predicting fracture risk and determining diagnostic QUS criteria of osteoporosis in non-industrialized populations in South America and elsewhere.

Original languageEnglish (US)
Pages (from-to)39-49
Number of pages11
JournalArchives of Osteoporosis
Issue number1-2
StatePublished - Dec 2011
Externally publishedYes


  • Bone mineral density
  • Calcaneal ultrasound
  • Colonos
  • Developing country
  • Shuar

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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