Trabecular Bone Score and Central Quantitative Computed Tomography for the Prediction of Vertebral Fragility Fractures in Postmenopausal Women
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: We aimed to investigate whether densitometry results and volumetric bone mineral density (vBMD) can predict vertebral fragility fractures (VFF) in postmenopausal women. Methods: We enrolled 271 postmenopausal women aged >45 years who visited our hospital for health check-ups between September 2016 and September 2017. The lumbar spine (LS) and femoral neck (FN) densitometry results and trabecular bone score (TBS) were calculated using dual energy X-ray absorptiometry. vBMD was assessed using central quantitative computed tomography (cQCT). Baseline and follow-up X-ray images were reviewed to evaluate thoracolumbar vertebral compression fractures (CFs), according to the Genant criteria. Results: At baseline, 76 patients (28.0%) had CF. Additional or progressive fractures were noted in 26 participants (9.6%) with a median follow-up of 19.5 months. The median TBS and cQCT were significantly higher in participants without baseline CF than those with baseline CF (P<0.001). During the follow-up, Kaplan–Meier analysis showed that T-scores of the LS and FN <-2.5, degraded microarchitecture based on the TBS (≤1.200), and vBMD <80 mg/cm3 was significantly associated with future osteoporotic CF. The final multivariate Cox regression analysis showed that baseline CF and low TBS and vBMD were significant risk factors for future VFF. Conclusions: Participants with baseline CF and degraded microarchitecture had higher CF predisposition. Moreover, cQCT can predict future vertebral fractures.
Abstract
Background: We aimed to investigate whether densitometry results and volumetric bone mineral density (vBMD) can predict vertebral fragility fractures (VFF) in postmenopausal women. Methods: We enrolled 271 postmenopausal women aged >45 years who visited our hospital for health check-ups between September 2016 and September 2017. The lumbar spine (LS) and femoral neck (FN) densitometry results and trabecular bone score (TBS) were calculated using dual energy X-ray absorptiometry. vBMD was assessed using central quantitative computed tomography (cQCT). Baseline and follow-up X-ray images were reviewed to evaluate thoracolumbar vertebral compression fractures (CFs), according to the Genant criteria. Results: At baseline, 76 patients (28.0%) had CF. Additional or progressive fractures were noted in 26 participants (9.6%) with a median follow-up of 19.5 months. The median TBS and cQCT were significantly higher in participants without baseline CF than those with baseline CF (P<0.001). During the follow-up, Kaplan–Meier analysis showed that T-scores of the LS and FN <-2.5, degraded microarchitecture based on the TBS (≤1.200), and vBMD <80 mg/cm3 was significantly associated with future osteoporotic CF. The final multivariate Cox regression analysis showed that baseline CF and low TBS and vBMD were significant risk factors for future VFF. Conclusions: Participants with baseline CF and degraded microarchitecture had higher CF predisposition. Moreover, cQCT can predict future vertebral fractures.
참고문헌 (30)
- Blake GM, "The clinical role of dual energy X-ray absorptiometry", Eur J Radiol, 71, pp.406~414 (2009)[DOI]
- Schott AM, "How hip and whole-body bone mineral density predict hip fracture in elderly women : the EPIDOS Prospective Study", Osteoporos Int, 8, pp.247~254 (1998)[DOI]
- Cummings SR, "Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group", Lancet, 341, pp.72~75 (1993)[DOI]
- Siris ES, "Bone mineral density thresholds for pharmacological intervention to prevent fractures", Arch Intern Med, 164, pp.1108~1112 (2004)[DOI]
- 공성혜, "Application of the Trabecular Bone Score in Clinical Practice", 대한골대사학회지, 28(2), pp.101~113 (2021), 대한골대사학회
- Kim K, "Is dual-energy absorptiometry accurate in the assessment of bone status of patients with chronic kidney disease?", Osteoporos Int, 32, pp.1859~1868 (2021)[DOI]
- Pothuaud L, "Correlations between grey-level variations in 2D projection images(TBS)and 3D microarchitecture : applications in the study of human trabecular bone microarchitecture", Bone, 42, pp.775~787 (2008)[DOI]
- 신미선, "Longitudinal Change in Trabecular Bone Score during and after Treatment of Osteoporosis in Postmenopausal Korean Women", 대한골대사학회지, 24(2), pp.117~124 (2017), 대한골대사학회[DOI]
- Li N, "Comparison of QCT and DXA : Osteoporosis detection rates in postmenopausal women", Int J Endocrinol, 2013, pp.895474~ (2013)[DOI]
- Gupta R, "Flat-panel volume CT: fundamental principles, technology, and applications", Radiographics, 28, pp.2009~2022 (2008)[DOI]
- Lee JE, "Comparisons of TBS and lumbar spine BMD in the associations with vertebral fractures according to the T-scores : A cross-sectional observation", Bone, 105, pp.269~275 (2017)[DOI]
- Samelson EJ, "Cortical and trabecular bone microarchitecture as an independent predictor of incident fracture risk in older women and men in the Bone Microarchitecture International Consortium(BoMIC) : a prospective study", Lancet Diabetes Endocrinol, 7, pp.34~43 (2019)[DOI]
- Odén A, "Assessing the impact of osteoporosis on the burden of hip fractures", Calcif Tissue Int, 92, pp.42~49 (2013)[DOI]
- Kanis JA, "The risk and burden of vertebral fractures in Sweden", Osteoporos Int, 15, pp.20~26 (2004)[DOI]
- Silva BC, "Trabecular bone score : perspectives of an imaging technology coming of age", Arq Bras Endocrinol Metabol, 58, pp.493~503 (2014)[DOI]
- Genant HK, "Vertebral fracture assessment using a semiquantitative technique", J Bone Miner Res, 8, pp.1137~1148 (1993)[DOI]
- Kado DM, "Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group", Arch Intern Med, 159, pp.1215~1220 (1999)[DOI]
- Lips P, "Quality of life in patients with osteoporosis", Osteoporos Int, 16, pp.447~455 (2005)[DOI]
- Schuit SC, "Fracture incidence and association with bone mineral density in elderly men and women : the Rotterdam Study", Bone, 34, pp.195~202 (2004)[DOI]
- Banks LM, "Effect of degenerative spinal and aortic calcification on bone density measurements in post-menopausal women : links between osteoporosis and cardiovascular disease?", Eur J Clin Invest, 24, pp.813~817 (1994)[DOI]
- Atiporn Therdyothin, "Trabecular bone score as an additional therapeutic decision tool in osteoporosis and osteopenia", Osteoporosis and Sarcopenia, 8(3), pp.123~130 (2022), 대한골다공증학회[DOI]
- Hans D, "Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density : the Manitoba study", J Bone Miner Res, 26, pp.2762~2769 (2011)[DOI]
- Leslie WD, "Lumbar spine texture enhances 10-year fracture probability assessment", Osteoporos Int, 25, pp.2271~2277 (2014)[DOI]
- Iki M, "Trabecular bone score(TBS)predicts vertebral fractures in Japanese women over 10 years independently of bone density and prevalent vertebral deformity : the Japanese Population-Based Osteoporosis(JPOS)cohort study", J Bone Miner Res, 29, pp.399~407 (2014)[DOI]
- Silva BC, "Trabecular bone score : a noninvasive analytical method based upon the DXA image", J Bone Miner Res, 29, pp.518~530 (2014)[DOI]
- Briot K, "Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women : the OPUS study", Bone, 57, pp.232~236 (2013)[DOI]
- Engelke K, "Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults : the 2007 ISCD Official Positions", J Clin Densitom, 11, pp.123~162 (2008)[DOI]
- Engelke K, "Quantitative computed tomography-current status and new developments", J Clin Densitom, 20, pp.309~321 (2017)[DOI]
- Leonhardt Y, "Opportunistic QCT bone mineral density measurements predicting osteoporotic fractures : A use case in a prospective clinical cohort", Front Endocrinol(Lausanne), 11, pp.586352~ (2020)[DOI]
- Mikolajewicz N, "HR-pQCT measures of bone microarchitecture predict fracture : Systematic review and meta-analysis", J Bone Miner Res, 35, pp.446~459 (2020)[DOI]