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Published in: Osteoporosis International 12/2016

01-12-2016 | Original Article

Evaluation of trabecular bone score in patients with a distal radius fracture

Authors: Y. H. Shin, H. S. Gong, D. H. Gang, H. S. Shin, J. Kim, G. H. Baek

Published in: Osteoporosis International | Issue 12/2016

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Abstract

Summary

We compared bone mineral density (BMD) and trabecular bone score (TBS) in postmenopausal women with a distal radius fracture older than 50 years with controls. Total hip BMD was significantly different, but TBS was not different between two groups, suggesting TBS does not reflect microarchitectural changes of the distal radius.

Introduction

The purpose of this study was to determine whether trabecular bone score (TBS) has additive value for discriminating distal radius fracture (DRF) independent of BMD.

Methods

We compared BMD and TBS in 258 postmenopausal women with a DRF older than 50 years of age with age- and body mass index (BMI)-matched controls who had no history of osteoporotic fracture. BMD was measured at the lumbar spine and hip using dual energy X-ray absorptiometry scans (GE Lunar Prodigy). TBS was calculated on the same spine image. A multivariate logistic regression analysis was used to analyze the odds ratio (OR) for the occurrence of DRF using age, BMI, lumbar spine BMD, total hip BMD, and TBS.

Results

Patients with a DRF had significantly lower BMDs at hip (neck, trochanter and total) than those of controls: 0.752 ± 0.097, 0.622 ± 0.089, and 0.801 ± 0.099 in patients and 0.779 ± 0.092, 0.648 ± 0.089, 0.826 ± 0.101 in controls. However, lumbar spine BMD and TBS were not significantly different between the groups (p = 0.400 and 0.864, respectively). The multivariate analysis indicated that only total hip BMD was significantly associated with the occurrence of DRF (OR, 10.231; 95 % confidence interval, 1.724–60.702; p = 0.010).

Conclusions

TBS was not different between women with a DRF and those without a history of osteoporotic fracture, suggesting that TBS measured at the lumbar spine does not reflect early microarchitectural changes of the distal radius. Only total hip BMD is associated with the risk of DRF in Korean women.
Literature
1.
go back to reference Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22(3):465–475CrossRefPubMed Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22(3):465–475CrossRefPubMed
2.
go back to reference Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42(3):467–475CrossRefPubMed Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42(3):467–475CrossRefPubMed
3.
go back to reference Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam study. Bone 34(1):195–202CrossRefPubMed Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, Uitterlinden AG, van Leeuwen JP, Pols HA (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam study. Bone 34(1):195–202CrossRefPubMed
4.
go back to reference Itoh S, Ohta T, Samejima H, Shinomiya K (1999) Bone mineral density in the distal radius in a healthy Japanese population and in relation to fractures of the distal radius. J Hand Surg (Br) 24(3):334–337CrossRef Itoh S, Ohta T, Samejima H, Shinomiya K (1999) Bone mineral density in the distal radius in a healthy Japanese population and in relation to fractures of the distal radius. J Hand Surg (Br) 24(3):334–337CrossRef
5.
go back to reference Lee JO, Chung MS, Baek GH, Oh JH, Lee YH, Gong HS (2010) Age- and site-related bone mineral densities in Korean women with a distal radius fracture compared with the reference Korean female population. J Hand Surg [Am] 35(9):1435–1441CrossRef Lee JO, Chung MS, Baek GH, Oh JH, Lee YH, Gong HS (2010) Age- and site-related bone mineral densities in Korean women with a distal radius fracture compared with the reference Korean female population. J Hand Surg [Am] 35(9):1435–1441CrossRef
6.
go back to reference Nordvall H, Glanberg-Persson G, Lysholm J (2007) Are distal radius fractures due to fragility or to falls? A consecutive case-control study of bone mineral density, tendency to fall, risk factors for osteoporosis, and health-related quality of life. Acta Orthop 78(2):271–277CrossRefPubMed Nordvall H, Glanberg-Persson G, Lysholm J (2007) Are distal radius fractures due to fragility or to falls? A consecutive case-control study of bone mineral density, tendency to fall, risk factors for osteoporosis, and health-related quality of life. Acta Orthop 78(2):271–277CrossRefPubMed
7.
go back to reference Dalle Carbonare L, Giannini S (2004) Bone microarchitecture as an important determinant of bone strength. J Endocrinol Investig 27(1):99–105CrossRef Dalle Carbonare L, Giannini S (2004) Bone microarchitecture as an important determinant of bone strength. J Endocrinol Investig 27(1):99–105CrossRef
8.
go back to reference Rubin CD (2005) Emerging concepts in osteoporosis and bone strength. Curr Med Res Opin 21(7):1049–1056CrossRefPubMed Rubin CD (2005) Emerging concepts in osteoporosis and bone strength. Curr Med Res Opin 21(7):1049–1056CrossRefPubMed
9.
go back to reference Cho YJ, Gong HS, Song CH, Lee YH, Baek GH (2014) Evaluation of physical performance level as a fall risk factor in women with a distal radial fracture. J Bone Joint Surg Am 96(5):361–365CrossRefPubMed Cho YJ, Gong HS, Song CH, Lee YH, Baek GH (2014) Evaluation of physical performance level as a fall risk factor in women with a distal radial fracture. J Bone Joint Surg Am 96(5):361–365CrossRefPubMed
10.
go back to reference Seeman E (2007) Is a change in bone mineral density a sensitive and specific surrogate of anti-fracture efficacy? Bone 41(3):308–317CrossRefPubMed Seeman E (2007) Is a change in bone mineral density a sensitive and specific surrogate of anti-fracture efficacy? Bone 41(3):308–317CrossRefPubMed
11.
go back to reference Silva BC, Leslie WD, Resch H, Lamy O, Lesnyak O, Binkley N, McCloskey EV, Kanis JA, Bilezikian JP (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29(3):518–530CrossRefPubMed Silva BC, Leslie WD, Resch H, Lamy O, Lesnyak O, Binkley N, McCloskey EV, Kanis JA, Bilezikian JP (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29(3):518–530CrossRefPubMed
12.
go back to reference Boutroy S, Hans D, Sornay-Rendu E, Vilayphiou N, Winzenrieth R, Chapurlat R (2013) Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study. Osteoporos Int 24(1):77–85CrossRefPubMed Boutroy S, Hans D, Sornay-Rendu E, Vilayphiou N, Winzenrieth R, Chapurlat R (2013) Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study. Osteoporos Int 24(1):77–85CrossRefPubMed
13.
go back to reference Briot K, Paternotte S, Kolta S, Eastell R, Reid DM, Felsenberg D, Gluer CC, Roux C (2013) Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women: the OPUS study. Bone 57(1):232–236CrossRefPubMed Briot K, Paternotte S, Kolta S, Eastell R, Reid DM, Felsenberg D, Gluer CC, Roux C (2013) Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women: the OPUS study. Bone 57(1):232–236CrossRefPubMed
14.
go back to reference Krueger D, Fidler E, Libber J, Aubry-Rozier B, Hans D, Binkley N (2014) Spine trabecular bone score subsequent to bone mineral density improves fracture discrimination in women. J Clin Densitom 17(1):60–65CrossRefPubMed Krueger D, Fidler E, Libber J, Aubry-Rozier B, Hans D, Binkley N (2014) Spine trabecular bone score subsequent to bone mineral density improves fracture discrimination in women. J Clin Densitom 17(1):60–65CrossRefPubMed
15.
go back to reference Pothuaud L, Barthe N, Krieg MA, Mehsen N, Carceller P, Hans D (2009) Evaluation of the potential use of trabecular bone score to complement bone mineral density in the diagnosis of osteoporosis: a preliminary spine BMD-matched, case-control study. J Clin Densitom 12(2):170–176CrossRefPubMed Pothuaud L, Barthe N, Krieg MA, Mehsen N, Carceller P, Hans D (2009) Evaluation of the potential use of trabecular bone score to complement bone mineral density in the diagnosis of osteoporosis: a preliminary spine BMD-matched, case-control study. J Clin Densitom 12(2):170–176CrossRefPubMed
16.
go back to reference Chung KC, Shauver MJ, Birkmeyer JD (2009) Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am 91(8):1868–1873CrossRefPubMedPubMedCentral Chung KC, Shauver MJ, Birkmeyer JD (2009) Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am 91(8):1868–1873CrossRefPubMedPubMedCentral
17.
go back to reference Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382CrossRefPubMed Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382CrossRefPubMed
18.
go back to reference Owen RA, Melton LJ 3rd, Ilstrup DM, Johnson KA, Riggs BL (1982) Colles’ fracture and subsequent hip fracture risk. Clin Orthop Relat Res 171:37–43 Owen RA, Melton LJ 3rd, Ilstrup DM, Johnson KA, Riggs BL (1982) Colles’ fracture and subsequent hip fracture risk. Clin Orthop Relat Res 171:37–43
19.
go back to reference Rozental TD, Makhni EC, Day CS, Bouxsein ML (2008) Improving evaluation and treatment for osteoporosis following distal radial fractures. A prospective randomized intervention. J Bone Joint Surg Am 90(5):953–961CrossRefPubMed Rozental TD, Makhni EC, Day CS, Bouxsein ML (2008) Improving evaluation and treatment for osteoporosis following distal radial fractures. A prospective randomized intervention. J Bone Joint Surg Am 90(5):953–961CrossRefPubMed
20.
go back to reference D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17(19):2265–2281CrossRefPubMed D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17(19):2265–2281CrossRefPubMed
21.
go back to reference Silva BC, Boutroy S, Zhang C, McMahon DJ, Zhou B, Wang J, Udesky J, Cremers S, Sarquis M, Guo XD, Hans D, Bilezikian JP (2013) Trabecular bone score (TBS)—a novel method to evaluate bone microarchitectural texture in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 98(5):1963–1970CrossRefPubMedPubMedCentral Silva BC, Boutroy S, Zhang C, McMahon DJ, Zhou B, Wang J, Udesky J, Cremers S, Sarquis M, Guo XD, Hans D, Bilezikian JP (2013) Trabecular bone score (TBS)—a novel method to evaluate bone microarchitectural texture in patients with primary hyperparathyroidism. J Clin Endocrinol Metab 98(5):1963–1970CrossRefPubMedPubMedCentral
22.
go back to reference Del Rio LM, Winzenrieth R, Cormier C, Di Gregorio S (2013) Is bone microarchitecture status of the lumbar spine assessed by TBS related to femoral neck fracture? A Spanish case-control study. Osteoporos Int 24(3):991–998CrossRefPubMed Del Rio LM, Winzenrieth R, Cormier C, Di Gregorio S (2013) Is bone microarchitecture status of the lumbar spine assessed by TBS related to femoral neck fracture? A Spanish case-control study. Osteoporos Int 24(3):991–998CrossRefPubMed
23.
go back to reference Stein EM, Liu XS, Nickolas TL, Cohen A, Thomas V, McMahon DJ, Zhang C, Yin PT, Cosman F, Nieves J, Guo XE, Shane E (2010) Abnormal microarchitecture and reduced stiffness at the radius and tibia in postmenopausal women with fractures. J Bone Miner Res 25(12):2572–2581CrossRefPubMedPubMedCentral Stein EM, Liu XS, Nickolas TL, Cohen A, Thomas V, McMahon DJ, Zhang C, Yin PT, Cosman F, Nieves J, Guo XE, Shane E (2010) Abnormal microarchitecture and reduced stiffness at the radius and tibia in postmenopausal women with fractures. J Bone Miner Res 25(12):2572–2581CrossRefPubMedPubMedCentral
24.
go back to reference Rozental TD, Deschamps LN, Taylor A, Earp B, Zurakowski D, Day CS, Bouxsein ML (2013) Premenopausal women with a distal radial fracture have deteriorated trabecular bone density and morphology compared with controls without a fracture. J Bone Joint Surg Am 95(7):633–642CrossRefPubMedPubMedCentral Rozental TD, Deschamps LN, Taylor A, Earp B, Zurakowski D, Day CS, Bouxsein ML (2013) Premenopausal women with a distal radial fracture have deteriorated trabecular bone density and morphology compared with controls without a fracture. J Bone Joint Surg Am 95(7):633–642CrossRefPubMedPubMedCentral
25.
go back to reference Pothuaud L, Carceller P, Hans D (2008) Correlations between grey-level variations in 2D projection images (TBS) and 3D microarchitecture: applications in the study of human trabecular bone microarchitecture. Bone 42(4):775–787CrossRefPubMed Pothuaud L, Carceller P, Hans D (2008) Correlations between grey-level variations in 2D projection images (TBS) and 3D microarchitecture: applications in the study of human trabecular bone microarchitecture. Bone 42(4):775–787CrossRefPubMed
26.
go back to reference Xie X, Barenholdt O (2001) Bone density and geometric properties of the distal radius in displaced and undisplaced Colles’ fractures: quantitative CT in 70 women. Acta Orthop Scand 72(1):62–66CrossRefPubMed Xie X, Barenholdt O (2001) Bone density and geometric properties of the distal radius in displaced and undisplaced Colles’ fractures: quantitative CT in 70 women. Acta Orthop Scand 72(1):62–66CrossRefPubMed
27.
go back to reference Webber T, Patel SP, Pensak M, Fajolu O, Rozental TD, Wolf JM (2015) Correlation between distal radial cortical thickness and bone mineral density. J Hand Surg 40(3):493–499CrossRef Webber T, Patel SP, Pensak M, Fajolu O, Rozental TD, Wolf JM (2015) Correlation between distal radial cortical thickness and bone mineral density. J Hand Surg 40(3):493–499CrossRef
28.
go back to reference Dhainaut A, Hoff M, Syversen U, Haugeberg G (2013) Cortical hand bone porosity and its association with distal radius fracture in middle aged and elderly women. PLoS One 8(7):e68405CrossRefPubMedPubMedCentral Dhainaut A, Hoff M, Syversen U, Haugeberg G (2013) Cortical hand bone porosity and its association with distal radius fracture in middle aged and elderly women. PLoS One 8(7):e68405CrossRefPubMedPubMedCentral
29.
go back to reference Bouxsein ML, Palermo L, Yeung C, Black DM (2002) Digital X-ray radiogrammetry predicts hip, wrist and vertebral fracture risk in elderly women: a prospective analysis from the study of osteoporotic fractures. Osteoporos Int 13(5):358–365CrossRefPubMed Bouxsein ML, Palermo L, Yeung C, Black DM (2002) Digital X-ray radiogrammetry predicts hip, wrist and vertebral fracture risk in elderly women: a prospective analysis from the study of osteoporotic fractures. Osteoporos Int 13(5):358–365CrossRefPubMed
30.
go back to reference Dhainaut A, Daibes K, Odinsson A, Hoff M, Syversen U, Haugeberg G (2014) Exploring the relationship between bone density and severity of distal radius fragility fracture in women. J Orthop Surg Res 9:57CrossRefPubMedPubMedCentral Dhainaut A, Daibes K, Odinsson A, Hoff M, Syversen U, Haugeberg G (2014) Exploring the relationship between bone density and severity of distal radius fragility fracture in women. J Orthop Surg Res 9:57CrossRefPubMedPubMedCentral
31.
go back to reference Cohen A, Dempster DW, Muller R, Guo XE, Nickolas TL, Liu XS, Zhang XH, Wirth AJ, van Lenthe GH, Kohler T, McMahon DJ, Zhou H, Rubin MR, Bilezikian JP, Lappe JM, Recker RR, Shane E (2010) Assessment of trabecular and cortical architecture and mechanical competence of bone by high-resolution peripheral computed tomography: comparison with transiliac bone biopsy. Osteoporos Int 21(2):263–273CrossRefPubMed Cohen A, Dempster DW, Muller R, Guo XE, Nickolas TL, Liu XS, Zhang XH, Wirth AJ, van Lenthe GH, Kohler T, McMahon DJ, Zhou H, Rubin MR, Bilezikian JP, Lappe JM, Recker RR, Shane E (2010) Assessment of trabecular and cortical architecture and mechanical competence of bone by high-resolution peripheral computed tomography: comparison with transiliac bone biopsy. Osteoporos Int 21(2):263–273CrossRefPubMed
32.
go back to reference Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KP, Melton LJ 3rd (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest 67(2):328–335CrossRefPubMedPubMedCentral Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KP, Melton LJ 3rd (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest 67(2):328–335CrossRefPubMedPubMedCentral
33.
go back to reference Arlot ME, Sornay-Rendu E, Garnero P, Vey-Marty B, Delmas PD (1997) Apparent pre- and postmenopausal bone loss evaluated by DXA at different skeletal sites in women: the OFELY cohort. J Bone Miner Res 12(4):683–690CrossRefPubMed Arlot ME, Sornay-Rendu E, Garnero P, Vey-Marty B, Delmas PD (1997) Apparent pre- and postmenopausal bone loss evaluated by DXA at different skeletal sites in women: the OFELY cohort. J Bone Miner Res 12(4):683–690CrossRefPubMed
34.
go back to reference Ensrud KE, Palermo L, Black DM, Cauley J, Jergas M, Orwoll ES, Nevitt MC, Fox KM, Cummings SR (1995) Hip and calcaneal bone loss increase with advancing age: longitudinal results from the study of osteoporotic fractures. J Bone Miner Res 10(11):1778–1787CrossRefPubMed Ensrud KE, Palermo L, Black DM, Cauley J, Jergas M, Orwoll ES, Nevitt MC, Fox KM, Cummings SR (1995) Hip and calcaneal bone loss increase with advancing age: longitudinal results from the study of osteoporotic fractures. J Bone Miner Res 10(11):1778–1787CrossRefPubMed
35.
go back to reference Riggs BL, Melton LJ, Robb RA, Camp JJ, Atkinson EJ, McDaniel L, Amin S, Rouleau PA, Khosla S (2008) A population-based assessment of rates of bone loss at multiple skeletal sites: evidence for substantial trabecular bone loss in young adult women and men. J Bone Miner Res 23(2):205–214CrossRefPubMed Riggs BL, Melton LJ, Robb RA, Camp JJ, Atkinson EJ, McDaniel L, Amin S, Rouleau PA, Khosla S (2008) A population-based assessment of rates of bone loss at multiple skeletal sites: evidence for substantial trabecular bone loss in young adult women and men. J Bone Miner Res 23(2):205–214CrossRefPubMed
36.
go back to reference Hans D, Goertzen AL, Krieg MA, Leslie WD (2011) Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res 26(11):2762–2769CrossRefPubMed Hans D, Goertzen AL, Krieg MA, Leslie WD (2011) Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res 26(11):2762–2769CrossRefPubMed
Metadata
Title
Evaluation of trabecular bone score in patients with a distal radius fracture
Authors
Y. H. Shin
H. S. Gong
D. H. Gang
H. S. Shin
J. Kim
G. H. Baek
Publication date
01-12-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 12/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3686-4

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