Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women: The OPUS study
Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women: The OPUS study
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DOI：
10.1016/j.bone.2013.07.040
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发表时间：
2013-11-01
期刊：
影响因子：
4.1
通讯作者：
Roux, Christian
中科院分区：
文献类型：
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作者：
Briot, Karine;Paternotte, Simon;Roux, Christian
本研究的目的是考虑骨小梁评分（TBS）是否改善面积骨矿物质密度（aBMD）测量单独为预测绝经后women.Patients和方法：OPUS研究进行了门诊欧洲妇女年龄在55岁以上，在5个中心招募6年以上。为了评估TBS的性能，可获得3个中心（基尔、巴黎和谢菲尔德）的基线Hologic扫描。对1007名女性（平均年龄65.9 ± 6.9岁）的骨折事件进行了随访。我们比较了TBS，aBMD及其组合的性能，通过使用净重新分类改进（NRI，主要分析）和受试者操作特征（ROC）c-统计分析，包括OR和曲线下面积（AUC）（二次分析）。在6年内，记录了82例（8.1%）发生临床椎体骨折的受试者和46例（4.6%）发生影像学椎体骨折的受试者。在预测临床腰椎骨折方面，TBS的表现明显优于腰椎（LS）aBMD（NRI = 16.3%，p = 0.007）。对于影像学椎体骨折，TBS和LS aBMD具有相似的预测能力，但TBS和LS aBMD的组合比LS aBMD单独使用增加了性能（NRI = 8.6%，p = 0.046），但预测与髋关节和股骨颈aBMD相似。在非骨质疏松妇女，TBS预测事件脆性骨折类似LS aBMD.Conclusions：这项前瞻性研究表明，在一般人群中，TBS是一个有用的工具，以提高性能的腰椎aBMD椎骨骨质疏松性骨折。(C)2013 Elsevier Inc. All rights reserved.
The objective of this study was to consider whether trabecular bone score (TBS) improves on areal bone mineral density (aBMD) measurement alone for the prediction of incident fractures in postmenopausal women.Patients and methods: The OPUS study was conducted in ambulatory European women aged above 55 years, recruited in 5 centers followed over 6 years. For the assessment of the performance of TBS, baseline Hologic scans from 3 centers (Kiel, Paris and Sheffield) were available. Follow-up for incident fractures was available for 1007 women (mean age 65.9 +/- 6.9 years). We compared the performance of TBS, aBMD, and their combination, by using net reclassification improvement (NRI, primary analysis) and receiver operator characteristic (ROC) c-statistical analysis with ORs and areas under the curves (AUCs) (secondary analyses).Results: 82 (8.1%) subjects with incident clinical osteoporotic fractures, and 46 (4.6%) with incident radiographic vertebral fractures were recorded over 6 years. Performance of TBS was significantly better than lumbar spine (LS) aBMD for the prediction of incident clinical osteoporotic fractures (NRI = 16.3%, p = 0.007). For radiographic vertebral fractures, TBS and LS aBMD had similar predictive power but the combination of TBS and LS aBMD increased the performance over LS aBMD alone (NRI = 8.6%, p = 0.046) but the prediction is similar to hip and femoral neck aBMD. In non osteoporotic women, TBS predicted incident fragility fractures similarly to LS aBMD.Conclusions: This prospective study shows that in general population, TBS is a useful tool to improve the performance of lumbar spine aBMD for vertebral osteoporotic fractures. (C) 2013 Elsevier Inc. All rights reserved.