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15-12-2009 | Bone health | Article

TBS may assess vertebral fracture risk for osteopenic women


Free abstract

MedWire News: Research indicates that trabecular bone score (TBS) may help assess vertebral fracture risk in postmenopausal women with osteopenia.

TBS – a gray-level analysis of two and three dimensional structures on dual-energy X-ray absorptiometry images – combined with bone mineral density (BMD) has been shown to improve identification of women at risk for osteoporotic vertebral fractures compared with BMD alone.

To determine whether TBS can be used to assess vertebral fracture risk in women with osteopenia, the team recruited 243 postmenopausal women aged 50–80 years with BMD T-scores of –1.0 and –2.5.

Overall, 81 had osteoporosis-related vertebral fractures and these women were compared with 162 age-matched controls.

Analysis showed that each 1 standard deviation incremental decrease in BMD increased the risk for vertebral fracture 1.54-fold, with an area under the receiver operating curve (AUC) score of 0.614.

For TBS, the odds ratio (OR) of vertebral fracture was 2.53 for each incremental decrease, with an AUC of 0.721 which significantly differed from that for BMD. For TBS plus BMD the OR was 2.54 and the AUC was 0.732.

The researchers caution in the journal Calcified Tissue International that their study assessed the ability to identify patients with a fracture rather than the clinically useful prediction of patients at risk for fractures.

“To achieve the former end, prospective, longitudinal studies are necessary,” conclude Renaud Winzenrieth (Hôpital Xavier Arnozan, Pessac, France) and co-workers.

“Nonetheless, the studies we have reported so far, albeit all case–control and retrospective, have been consistent in their findings; and this suggests to us that such prospective, longitudinal studies to assess the value and added value of the TBS in the assessment of fracture risk are indeed warranted.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Lynda Williams

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