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Osteoporosis International
Published in: Osteoporosis International 3/2013

01-03-2013 | Original Article

Effects of anti-resorptive agents on trabecular bone score (TBS) in older women

Authors: M. A. Krieg, B. Aubry-Rozier, D. Hans, W. D. Leslie, for the Manitoba Bone Density Program

Published in: Osteoporosis International | Issue 3/2013

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Abstract

Summary

We evaluated the longitudinal effects of anti-resorptive agents (534 treated women vs. 1,150 untreated) on lumbar spine bone mineral density (BMD) and trabecular bone score (TBS). TBS was responsive to treatment in women over age 50. The treatment-related increase in TBS was less than the increase in BMD, which is consistent with bone texture preservation.

Introduction

In addition to inducing an increase in BMD, anti-resorptive agents also help to preserve bone architecture. TBS, a new gray-level texture measurement, correlates with 3D parameters of bone micro-architecture independent of BMD. Our objective was to evaluate the longitudinal effects of anti-resorptive agents on lumbar spine BMD and TBS.

Methods

Women (≥50 years), from the BMD program database for the province of Manitoba, Canada, who had not received any anti-resorptive drug prior to their initial dual X-ray absorptiometry (DXA) exam were divided into two groups: untreated, those without any anti-resorptive drug over the course of follow-up, and treated, those with a non-estrogen anti-resorptive drug (86 % bisphosphonates, 10 % raloxifene, and 4 % calcitonin). Lumbar spine TBS was calculated for each lumbar spine DXA examination. Changes in TBS and BMD between baseline and follow-up (mean follow-up 3.7 years), expressed in percentage per year, were compared between the two groups.

Results

A total of 1,150 untreated women and 534 treated women met the inclusion criteria. Only a weak correlation was seen between BMD and TBS in either group. Significant intergroup differences in BMD change and TBS change were observed over the course of follow-up (p < 0.001). Similar mean decreases in BMD and TBS (−0.36 %/year and −0.31 %/year, respectively) were seen for untreated subjects (both p < 0.001). Conversely, treated subjects exhibited a significant mean increase in BMD (+1.86 %/year, p < 0.002) and TBS (+0.20 %/year, p < 0.001).

Conclusion

TBS is responsive to treatment with non-estrogen anti-resorptive drug therapy in women over age 50. The treatment-related increase in TBS is less than the increase in BMD, which is consistent with bone texture preservation.
Literature
1.
Czerwinski E, Badurski JE, Marcinowska-Suchowierska E, Osieleniac J (2007) Current understanding of osteoporosis according to the position of the World Health Organization (WHO) and International Osteoporosis Foundation. Ortop Traumatol Rehabil 9:337–356PubMed
2.
Browner WS, Pressman AR, Nevitt MC et al (1996) Mortality following fractures in older women. The study of osteoporotic fractures. Arch Intern Med 156:1521–1525PubMedCrossRef
3.
Hannan EL, Magaziner J, Wang JJ et al (2001) Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes. JAMA 285:2736–2742PubMedCrossRef
4.
Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRef
5.
Looker AC, Orwoll ES, Johnston CC Jr et al (2009) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768CrossRef
6.
Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733PubMedCrossRef
7.
World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO study group. World Health Organ Tech Rep Ser 843:1–129
8.
Johnell O, Kanis JA, Oden E et al (2005) Predictive value of BMD for hip and other fractures. J Bone Miner Res 20(7):1185–1194PubMedCrossRef
9.
Hordon LD, Raisi M, Paxton S, Beneton MM, Kanis JA, Aaron JE (2000) Trabecular architecture in women and men of similar bone mass with and without vertebral fracture. Part I. 2-D histology. Bone 27(2):271–276PubMedCrossRef
10.
Link TM, Majumdar S (2004) Current diagnostic techniques in the evaluation of bone architecture. Curr Osteoporos Rep 2(2):47–52PubMedCrossRef
11.
Rubin CD (2005) Emerging concepts in osteoporosis and bone strength. Curr Med Res Opin 21(7):1049–1056PubMedCrossRef
12.
Dalle Carbonare L, Giannini S (2004) Bone microarchitecture as an important determinant of bone strength. J Endocrinol Invest 27(1):99–105PubMed
13.
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 42:775–787PubMedCrossRef
14.
Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg M-A (2011) Correlations between TBS, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J Clin Densitom 14(3):302–312PubMedCrossRef
15.
Piveteau T, Winzenrieth R, Hans D (2011) Trabecular Bone Score (TBS) the new parameter of 2D texture analysis for the evaluation of 3D bone micro architecture status. J Clin Densitom 14(2):169
16.
Winzenrieth R, Piveteau T, Hans D (2011) Assessment of correlations between 3D μCT microarchitecture parameters and TBS: effects of resolution and correlation with TBS DXA measurements. J Clin Densitom 14(2):169
17.
Pothuaud L, Barthe N, Krieg M-A, 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):170–176PubMedCrossRef
18.
Rabier B, Héraud A, Grand-Lenoir C, Winzenrieth R, Hans D (2010) A multicentre, retrospective case–control study assessing the role of trabecular bone score (TBS) in menopausal Caucasian women with low areal bone mineral density (BMDa): analysing the odds of vertebral fracture. Bone 46(1):176–181PubMedCrossRef
19.
Winzenrieth R, Dufour R, Pothuaud L, Hans D (2010) A retrospective case–control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture. Calcif Tissue Int 86(2):104–109PubMedCrossRef
20.
Winzenrieth R, Cormier C, Del Rio L, Di Gregorio S (2012) Is bone micro-architecture status at spine assessed by TBS related to femoral neck fracture? A Spanish case–control study. Osteoporosis International (in press)
21.
Colson F, Winzenrieth R (2011) Assessment of osteopenic women microarchitecture with and without osteoporotic fracture by TBS on a new generation bone densitometer. In: ISCD annual meeting. April 6-9. Miami, Florida, USA
22.
Bréban S, Kolta S, Briot K, Ghazi M, Fechtenbaum J, Dougados M, Roux C (2010) Combination of bone mineral density and trabecular bone score for vertebral fracture prediction in secondary osteoporosis. In: Annual meeting of the American Society of Bone and Mineral Research., Toronto, Canada; Oct. 15-19. SA0297
23.
Hans D, Goertzen A, Krieg M-A, Leslie WD (2011) Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res 16(11):2762–2769CrossRef
24.
Boutroy S, Hans D, Sornay-Rendu E, Vilayphiou N, Winzenrieth R, Chapurlat R (2010) Trabecular bone score helps classifying women at risk of fracture: a prospective analysis within the OFELY study. J Bone Miner Res 25(S1):89
25.
Popp AW, Meer S, Hans D, Krieg M-A, Perrelet R, Lippuner K (2012) Bone mineral density (BMD) combined with microarchitecture parameters (TBS) significantly improves the identification of women at high risk of fracture: the SEMOF cohort study. In: IOF-ECCEO12 European congress on osteoporosis and osteoarthritis. March 21 to 24. Bordeaux, France. P598
26.
Leslie WD, Pahlavan PS, Tsang JF, Lix LM (2009) Prediction of hip and other osteoporotic fractures from hip geometry in a large clinical cohort. Osteoporos Int 10:1767–1774CrossRef
27.
Leslie WD, Metge C (2003) Establishing a regional bone density program: lessons from the Manitoba experience. J Clin Densitom 6:275–282PubMedCrossRef
28.
Leslie WD, Caetano PA, MacWilliam LR et al (2005) Construction and validation of a population-based bone densitometry database. J Clin Densitom 8:25–30PubMedCrossRef
29.
Roos NP, Shapiro E (1999) Revisiting the Manitoba Centre for Health Policy and Evaluation and its population-based health information system. Med Care 37:JS10–JS14PubMedCrossRef
30.
Kanis JA, McCloskey E, Johansson H et al (2008) A reference standard for the description of osteoporosis. Bone 42:467–475PubMedCrossRef
31.
Binkley N, Kiebzak GM, Lewiecki EM et al (2005) Recalculation of the NHANES database SD improves T-score agreement and reduces osteoporosis prevalence. J Bone Miner Res 20:195–201PubMedCrossRef
32.
Faulkner KG, Wacker WK, Barden HS et al (2006) Femur strength index predicts hip fracture independent of bone density and hip axis length. Osteoporos Int 17:593–599PubMedCrossRef
33.
Boudousq V, Goulart DM, Dinten JM et al (2005) Image resolution and magnification using a cone beam densitometer: optimizing data acquisition for hip morphometric analysis. Osteoporos Int 16:813–822PubMedCrossRef
34.
Leslie WD (2006) The importance of spectrum bias on bone density monitoring in clinical practice. Bone 39:361–368PubMedCrossRef
35.
Seeman E, Delmas PD (2006) Bone quality—the material and structural basis of bone strength and fragility. N Engl J Med 354(21):2250–2261PubMedCrossRef
36.
Russell RG, Xia Z, Dunford JE, Oppermann U, Kwaasi A, Hulley PA, Kavanagh KL, Triffitt JT, Lundy MW, Phipps RJ, Barnett BL, Coxon FP, Rogers MJ, Watts NB, Ebetino FH (2007) Bisphosphonates: an update on mechanisms of action and how these relate to clinical efficacy. Ann N Y Acad Sci 1117:209–257, ReviewPubMedCrossRef
37.
Glüer CC, Blake G, Lu Y, Blunt BA, Jergas M, Genant HK (1995) Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporos Int 5(4):262–270PubMedCrossRef
38.
Rizzoli R, Chapurlat RD, Laroche JM, Krieg MA, Thomas T, Frieling I, Boutroy S, Laib A, Bock O, Felsenberg D (2012) Effects of strontium ranelate and alendronate on bone microstructure in women with osteoporosis. Results of a 2-year study. Osteoporos Int 23(1):305–315PubMedCrossRef
39.
Popp AW, Buffat H, Lamy O et al (2012) Beneficial effect of zoledronate compared to placebo on spine BMD and microarchitecture (TBS) parameters in postmenopausal women with osteoporosis. A 3-year study. Osteoporosis Int 23(Suppl 2):S85–S386, P599
40.
Günther B, Popp AW, Stoll D et al (2012) Beneficial effect of PTH on spine BMD and microarchitecture (TBS) parameters in postmenopausal women with osteoporosis. A 2-year study. Osteoporosis Int 23(Suppl 2):S85–S386, P609
41.
Hadji P, Kalder M, Kauka A et al (2012) Effects of exemestane and tamoxifen treatments on bone quantity and quality in patient with breast cancer. Osteoporosis Int 23(Suppl 2):S85–S386, P518
42.
Hans D, Krieg MA, Lamy O, Felsenberg D (2012) Beneficial effects of strontium ranelate compared to alendronate on trabecular bone score in post menopausal osteoporotic women. A 2-year study. Osteoporosis Int 23(Suppl 2):S85–S386, P471
Metadata
Title
Effects of anti-resorptive agents on trabecular bone score (TBS) in older women
Authors
M. A. Krieg
B. Aubry-Rozier
D. Hans
W. D. Leslie
for the Manitoba Bone Density Program
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 3/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-012-2155-y

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