Determinants of trabecular bone score and prevalent vertebral fractures in women with fragility fractures: a cross-sectional sub-study of NoFRACT

Abstract

Determinants of trabecular bone score (TBS) and vertebral fractures assessed semiquantitatively (SQ1-SQ3) were studied in 496 women with fragility fractures. TBS was associated with age, parental hip fracture, alcohol intake and BMD, not SQ1-SQ3 fractures. SQ1-SQ3 fractures were associated with age, prior fractures, and lumbar spine BMD, but not TBS. Introduction Trabecular bone score (TBS) and vertebral fractures assessed by semiquantitative method (SQ1-SQ3) seem to reflect different aspects of bone strength. We therefore sought to explore the determinants of and the associations between TBS and SQ1-SQ3 fractures. Methods This cross-sectional sub-study of the Norwegian Capture the Fracture Initiative included 496 women aged ≥ 50 years with fragility fractures. All responded to a questionnaire about risk factors for fracture, had bone mineral density (BMD) of femoral neck and/or lumbar spine assessed, TBS calculated, and 423 had SQ1-SQ3 fracture assessed. Results Mean (SD) age was 65.6 years (8.6), mean TBS 1.27 (0.10), and 33.3% exhibited SQ1-SQ3 fractures. In multiple variable analysis, higher age (β per SD = − 0.26, 95% CI: − 0.36,− 0.15), parental hip fracture (β = − 0.29, 95% CI: − 0.54,− 0.05), and daily alcohol intake (β = − 0.43, 95% CI − 0.79, − 0.08) were associated with lower TBS. Higher BMD of femoral neck (β per SD = 0.34, 95% CI 0.25-0.43) and lumbar spine (β per SD = 0.40, 95% CI 0.31-0.48) were associated with higher TBS. In multivariable logistic regression analyses, age (OR per SD = 1.94, 95% CI 1.51-2.46) and prior fragility fractures (OR = 1.71, 95% CI 1.09-2.71) were positively associated with SQ1-SQ3 fractures, while lumbar spine BMD (OR per SD = 0.75 95% CI 0.60-Osteoporosis International (2020) 31:505-514 https://doi.# The Author(s) 2019 0.95) was negatively associated with SQ1-SQ3 fractures. No association between TBS and SQ1-SQ3 fractures was found. Conclusion Since TBS and SQ1-SQ3 fractures were not associated, they may act as independent risk factors, justifying the use of both in post-fracture risk assessment.

Proportion and Risk Factors of Silent Vertebral Fractures Among Egyptian Females With Fragility Hip Fracture Presenting to the Emergency Room of Ain Shams University Hospitals

“…The present study showed that in the studied group, 16 (10.7%) patients had vertebral fractures. This is in agreement with what was previously reported in the study [26], which showed that 33.3% of patients had associated vertebral fracture with the hip fracture while being presenting to emergency services. The presence of a vertebral fracture is a risk factor for subsequent fracture at any given BMD.…”

Osteoporosis Screening: Applied Methods and Technological Trends

“…Recent work did not find relation between TBS and a vertebral fracture severity index based on VFA; the authors suggested the use of both indices to characterize bone strength [42]. A similar result was found when comparing TBS to quantitative ultrasound (QUS), suggesting that both techniques assess different characteristics of bones [43].…”

Focal osteoporosis defect is associated with vertebral compression fracture prevalence in a bone mineral density‐independent manner

“… 30 , 31 , 32 , 33 However, there is still a shortage of suitable methods for the focal osteoporosis structural integrity quantification in clinical CT scans. 34 Unlike variogram analysis, such as the Trabecular Bone Score (TBS), which is widely applied in DXA devices for structural integrity evaluation, 35 , 36 , 37 , 38 CT‐based quantification studies drew more attention on apparent microarchitecture estimation. To date, several groups attempted to measure the microarchitecture in multi‐detector CT scanners and revealed its association with osteoporosis status.…”