The Trabecular Bone Score as a Predictor for Thalassemia-Induced Vertebral Fractures in Northeastern Thailand

Teawtrakul, Nattiya; Chukanhom, Sukanya; Charoensri, Suranut; Somboonporn, Charoonsak; Pongchaiyakul, Chatlert

doi:10.1155/2020/4634709

Cited by 10 publications

(14 citation statements)

References 31 publications

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“…The prevalence of osteoporosis and fracture in TDT patients was highly heterogeneous, depending on patient characteristics, comorbidities, diagnostic criteria of osteoporosis, assessment method, definition of fracture, and sample size. Our findings were consistent with previous reports 10 , 12 , which found that approximately half of adults with TDT had BMD values below the expected range for their age. In a recent study conducted in Iran 13 , the prevalence of low BMD was found to be 74.6%, with half of the participants having hypogonadism, compared to 32.1% in our study.…”

Section: Discussionsupporting

confidence: 93%

Association of osteoporosis and sarcopenia with fracture risk in transfusion-dependent thalassemia

Thavonlun,

Houngngam,

Kingpetch

et al. 2023

Sci Rep

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Patients with transfusion-dependent thalassemia (TDT) have an increased risk of osteoporosis and fractures. They also have several potential factors associated with sarcopenia. There has been currently no study on sarcopenia and its association with falls and fractures in TDT. This study aims to determine the prevalence of and factors associated with osteoporosis, fragility fractures, and sarcopenia in adults with TDT. A cross-sectional study was conducted at the hematologic clinic at King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Clinical data and laboratory testing were collected. Bone mineral density and morphometric vertebral fracture were assessed. Sarcopenia was defined using the 2014 and 2019 Asian Working Group for Sarcopenia (AWGS) criteria. We included 112 TDT patients aged 35.1 ± 12.5 years. The prevalence of osteoporosis was 38.4%. Fragility fractures were found in 20.5% of patients. Lower BMI (OR 0.29; 95% CI 0.12–0.72, P = 0.007) and hypogonadal state (OR 3.72; 95% CI 1.09–12.74, P = 0.036) were independently associated with osteoporosis. According to the 2014 AWGS criteria, the prevalence of overall sarcopenia and severe sarcopenia was 44.6% and 13.4%, respectively. Severe sarcopenia was strongly associated with fragility fractures (OR 4.59, 95% CI 1.21–17.46, P = 0.025). In conclusion, osteoporosis, fragility fractures, and sarcopenia were prevalent in adults with TDT. Severe sarcopenia was associated with fragility fractures. Early osteoporosis and sarcopenia screening and prevention may reduce fracture risk and its complications in these patients.

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Section: Discussionsupporting

confidence: 93%

Association of osteoporosis and sarcopenia with fracture risk in transfusion-dependent thalassemia

Thavonlun,

Houngngam,

Kingpetch

et al. 2023

Sci Rep

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“…Similarly, in another study of 407 postmenopausal women from Police General Hospital in Bangkok, the odds ratio of fracture was 1.35 for a one SD decrease in TBS [ 76 ]. Additionally, combined low TBS and BMD was found to be associated with a 4-fold increased risk vertebral fracture among 86 patients with thalassemia [ 77 ].…”

Section: Evaluation and Management Of Osteoporosis In Thailandmentioning

confidence: 99%

Current issues in evaluation and management of osteoporosis in Thailand

Charoenngam

Pongchaiyakul

2023

Osteoporosis and Sarcopenia

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“…In differentiated thyroid carcinomas, TBS was found to be lower in patients receiving long-term suppressive doses of thyroid-stimulating hormone than in patients receiving shorter-term therapy ( 92 – 94 ). Some other studies also evaluated TBS in thalassemia major ( 95 , 96 ), Human Immunodeficiency virus-acquired immunodeficiency syndrome (HIV-AIDS) ( 97 , 98 ), Klinefelter syndrome ( 99 ), Ehlers-Danlos syndrome ( 100 ), Down syndrome ( 101 ), and short stature ( 102 ).…”

Section: Tbs and Fracture Risk Prediction In Patients With Diabetes A...mentioning

confidence: 99%

Update on trabecular bone score

Palomo¹,

Muszkat²,

Weiler³

et al. 2022

Archives of Endocrinology and Metabolism

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Trabecular bone score (TBS) is an indirect and noninvasive measure of bone quality. A low TBS indicates degraded bone microarchitecture, predicts osteoporotic fracture, and is partially independent of clinical risk factors and bone mineral density (BMD). There is substantial evidence supporting the use of TBS to assess vertebral, hip, and major osteoporotic fracture risk in postmenopausal women, as well as to assess hip and major osteoporotic fracture risk in men aged > 50 years. TBS complements BMD information and can be used to adjust the FRAX (Fracture Risk Assessment) score to improve risk stratification. While TBS should not be used to monitor antiresorptive therapy, it may be potentially useful for monitoring anabolic therapy. There is also a growing body of evidence indicating that TBS is particularly useful as an adjunct to BMD for fracture risk assessment in conditions associated with increased fracture risk, such as type-2 diabetes, chronic corticosteroid excess, and other conditions wherein BMD readings are often misleading. The interference of abdominal soft tissue thickness (STT) on TBS should also be considered when interpreting these findings because image noise can impact TBS evaluation. A new TBS software version based on an algorithm that accounts for STT rather than BMI seems to correct this technical limitation and is under development. In this paper, we review the current state of TBS, its technical aspects, and its evolving role in the assessment and management of several clinical conditions.

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The Trabecular Bone Score as a Predictor for Thalassemia-Induced Vertebral Fractures in Northeastern Thailand

Cited by 10 publications

References 31 publications

Association of osteoporosis and sarcopenia with fracture risk in transfusion-dependent thalassemia

Association of osteoporosis and sarcopenia with fracture risk in transfusion-dependent thalassemia

Current issues in evaluation and management of osteoporosis in Thailand

Update on trabecular bone score

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