Spine bone texture assessed by trabecular bone score (TBS) predicts osteoporotic fractures in men: The Manitoba Bone Density Program
Spine bone texture assessed by trabecular bone score (TBS) predicts osteoporotic fractures in men: The Manitoba Bone Density Program
复制标题
DOI：
10.1016/j.bone.2014.06.034
复制
发表时间：
2014-10-01
期刊：
影响因子：
4.1
通讯作者：
Hans, D.
中科院分区：
文献类型：
--
作者：
Leslie, W. D.;Aubry-Rozier, B.;Hans, D.
四分之一的骨质疏松性骨折发生在男性身上。TBS是一种来自腰椎DXA图像纹理的灰度测量，与微结构和骨折风险无关，与BMD无关。先前的研究报道了脊柱TBS预测女性骨质疏松性骨折的能力。我们的目的是评估TBS预测男性临床骨质疏松性骨折的能力。方法：从数据库（加拿大马尼托巴省）中确定3620名基线DXA（股骨颈，脊柱）时年龄为bb0 = 50（平均67.6岁）的男性。在骨密度测试后评估健康服务记录是否存在非创伤性骨质疏松性骨折。腰椎TBS来源于脊柱DXA，对临床参数和结果不知情。我们使用Cox比例风险回归分析调整临床危险因素（FRAX不含骨密度）、骨质疏松治疗和骨密度（髋关节或脊柱）后首次骨折的时间。结果：平均随访时间为4.5年。183例（5.1%）男性发生严重骨质疏松性骨折（MOF）， 91例（2.5%）临床椎体骨折（CVF）， 46例（1.3%）髋部骨折（HF）。脊柱骨密度与脊柱TBS的相关性不高（r = 031），低于脊柱与髋部骨密度的相关性（r = 0.68）。骨折患者与非骨折患者相比，MOF （p < 0.001）、HF （p < 0.001）和CVF （p = 0.003）的脊柱TBS发生率明显较低。TBS识别骨折的受者工作特征曲线下面积（AUC）明显优于随机（MOF AUC = 0.59, p < 0.001; HF AUC = 0.67, p < 0.001; CVF AUC = 0.57, p = 0.032）。在没有BMD和骨质疏松治疗的FRAX调整模型中，TBS预测MOF和HF（但不预测CVF）。在进一步调整髋关节骨密度或脊柱骨密度后，TBS仍然是HF（但不是MOF）的预测因子。结论：我们观察到脊柱TBS预测MOF和HF独立于临床FRAX评分，男性HF独立于FRAX和BMD。需要更多的偶发性骨折研究来证实这些发现。(C) 2014爱思唯尔公司版权所有。
Introduction: One quarter of osteoporotic fractures occur in men. TBS, a gray-level measurement derived from lumbar spine DXA image texture, is related to microarchitecture and fracture risk independently of BMD. Previous studies reported the ability of spine TBS to predict osteoporotic fractures in women. Our aim was to evaluate the ability of TBS to predict clinical osteoporotic fractures in men.Methods: 3620 men aged >= 50 (mean 67.6 years) at the time of baseline DXA (femoral neck, spine) were identified from a database (Province of Manitoba, Canada). Health service records were assessed for the presence of non-traumatic osteoporotic fracture after BMD testing. Lumbar spine TBS was derived from spine DXA blinded to clinical parameters and outcomes. We used Cox proportional hazard regression to analyze time to first fracture adjusted for clinical risk factors (FRAX without BMD), osteoporosis treatment and BMD (hip or spine).Results: Mean followup was 4.5 years. 183 (5.1%) men sustain major osteoporotic fractures (MOF), 91 (2.5%) clinical vertebral fractures (CVF), and 46 (1.3%) hip fractures (HF). Correlation between spine BMD and spine TBS was modest (r = 031), less than correlation between spine and hip BMD (r = 0.68). Significantly lower spine TBS were found in fracture versus non-fracture men for MOF (p < 0.001), HF (p < 0.001) and CVF (p = 0.003). Area under the receiver operating characteristic curve (AUC) for incident fracture discrimination with TBS was significantly better than chance (MOF AUC = 0.59, p < 0.001; HF AUC = 0.67, p < 0.001; CVF AUC = 0.57, p = 0.032). TBS predicted MOF and HF (but not CVF) in models adjusted for FRAX without BMD and osteoporosis treatment. TBS remained a predictor of HF (but not MOF) after further adjustment for hip BMD or spine BMD.Conclusion: We observed that spine TBS predicted MOF and HF independently of the clinical FRAX score, HF independently of FRAX and BMD in men. Studies with more incident fractures are needed to confirm these findings. (C) 2014 Elsevier Inc. All rights reserved.