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14-09-2009 | Bone health | Article

Trabecular bone score may identify patients at risk for vertebral fracture

Abstract

Free abstract

MedWire News: The trabecular bone score (TBS) could help identify individuals at risk for osteoporotic vertebral fracture, suggests research published in the journal Bone.

The TBS is a novel dual-energy X-ray absorptiometry parameter measuring thickness and volume of trabecular bone microarchitecture, and has recently been shown to predict risk for fracture, explain Didier Hans (Lausanne University Hospital, Switzerland) and co-workers.

To determine the relationship between TBS and specific risk for vertebral fracture, the team examined TBS and areal bone mineral density (BMD) in 42 women with osteoporotic vertebral fractures and 126 age-matched women without fracture.

Weight and body mass index (BMI) were higher in women with fractures than controls, but BMD and TBS were both lower.

The odds ratio (OR) for vertebral fracture was 3.20 for each incremental decrease in TBS and 1.95 for each incremental decrease in BMD, rising to an OR of 3.62 when these factors were combined. In receiver operating curve analysis, the area under the curve score (AUC) was greater for TBS than BMD (0.746 vs 0.662), report the researchers.

The team found that women with osteoporosis had significantly lower BMD and TBS than those without osteoporosis, and the combined OR for fracture was higher than for BMD alone (OR=4.04 vs 2.43 and AUC=0.835 vs 0.718).

Among women with osteopenia, TBS was lower in women with fractures than those without, but BMD did not significantly differ, and the OR for fracture was significant for TBS (OR=2.82) but not for BMD. Although AUC was also significantly only for TBS in this population, there was no significant difference in sensitivity or specificity for TBS versus BMD.

“The TBS warrants further study as to whether it has any clinical application in osteoporosis detection and the evaluation of fracture risk,” Hans et al conclude.

They suggest the TBS may be useful for identifying osteopenic patients at highest risk for fracture or for managing young patients with osteoporosis.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

By Lynda Williams

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