Comparing Bone Microarchitecture by Trabecular Bone Score (TBS) in Caucasian American Women with and Without Osteoporotic Fractures
Comparing Bone Microarchitecture by Trabecular Bone Score (TBS) in Caucasian American Women with and Without Osteoporotic Fractures
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DOI：
10.1007/s00223-014-9882-3
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发表时间：
2014-09-01
影响因子：
4.2
通讯作者：
Hans, D.
中科院分区：
文献类型：
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作者：
Leib, E.;Winzenrieth, R.;Hans, D.
几项横断面研究表明，TBS有能力区分欧洲人群中有骨折和没有骨折的人。这项研究的目的是评估TBS在美国一大批女性高加索人群中区分骨折患者和非骨折患者的能力。这是一项病例对照研究，对象是2165名40岁及以上的高加索美国女性。患有疾病或服用已知影响骨代谢的药物的患者被排除在外。骨折组(n=289)至少有一处低能量骨折。在L1-L4测量BMD，根据同一DXA图像直接计算TBS。使用描述性统计和差异推理检验。建立了单变量和多变量Logistic回归模型，以调查自变量和骨折状态之间的可能联系。计算每标准差减少的优势比(OR)和ROC曲线下面积作为判别参数。TBS与BMD、BMI呈弱相关(r分别为0.33和-0.17，p<；0.01)。平均年龄、体重、BMD和TBS在对照组和骨折组之间有显著差异(均P<0.05)，而BMI和身高则无差异。在调整了年龄、体重、BMD、吸烟、母亲和家庭骨折史后，TBS(但不是BMD)仍然是骨折的重要预测因素：即使在调整后也是1.28[1.13-1.46]。在美国女性人群中，TBS再次能够区分骨折患者和非骨折患者，即使在调整了其他临床风险因素后也是如此。
Several cross-sectional studies have shown the ability of the TBS to discriminate between those with and without fractures in European populations. The aim of this study was to assess the ability of TBS to discriminate between those with and without fractures in a large female Caucasian population in the USA. This was a case-control study of 2,165 Caucasian American women aged 40 and older. Patients with illness or taking medications known to affect bone metabolism were excluded. Those in the fracture group (n = 289) had at least one low-energy fracture. BMD was measured at L1-L4, TBS calculated directly from the same DXA image. Descriptive statistics and inferential tests for difference were used. Univariate and multivariate logistic regression models were created to investigate possible association between independent variables and the status of fracture. Odds ratios per standard deviation decrease (OR) and areas under the ROC curve were calculated for discriminating parameters. Weak correlations were observed between TBS and BMD and between TBS and BMI (r = 0.33 and -0.17, respectively, p < 0.01). Mean age, weight, BMD and TBS were significantly different between control and fracture groups (all p a parts per thousand currency sign 0.05), whereas no difference was noted for BMI or height. After adjusting for age, weight, BMD, smoking, and maternal and family history of fracture, TBS (but not BMD) remained a significant predictor of fracture: OR 1.28[1.13-1.46] even after adjustment. In a US female population, TBS again was able to discriminate between those with and those without fractures, even after adjusting for other clinical risk factors.