scholarly journals P159 Patients with Inflammatory Bowel Disease Present with Lower Trabecular Bone Scores

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S238-S239
Author(s):  
A Yarur ◽  
B Alexandra ◽  
P Beniwal-Patel ◽  
D Stein ◽  
L Nunez ◽  
...  
Keyword(s):  
Disease Activity ◽  
Trabecular Bone ◽  
Smoking Status ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Indirect Measurement ◽  
Pharmacologic Therapy ◽  
Mineral Density ◽  
Z Scores ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel diseases (IBD) have lower bone mineral density (BMD). However, BMD does not reflect bone micro-structure/geometry, nor indicates the intrinsic properties of bone tissue. The trabecular bone score (TBS) delivers an indirect measurement of bone microarchitecture and predicts fracture risk independent of bone density. The aim of this study was to assess if patients with IBD present with lower TBS vs a healthy control (HC) population and to identify variables associated with lower TBS. Methods This prospective cohort study included patients with active Crohn’s disease (CD) or ulcerative colitis (UC) and a matched HC group. Patients with ostomies, short gut or known endocrine co-morbidities associated with low BMD, patients with osteoporosis on pharmacologic therapy were excluded. L1-L4 TBS and BMD parameters were determined by dual-energy X-ray absorptiometry (DXA) using a GE Lunar iDXA scan and TBS iNsight™ and GE enCORE™. Other collected variables included demographics, disease phenotype, laboratories (25-OH vitamin D [25OHD] and parathyroid hormone levels [PTH]), disease activity (c-reactive protein [CRP], simple endoscopic score [SES-CD] in CD, and endoscopic Mayo score [EMS] in UC). IBD severity was stratified based on endoscopy: mild (EMS=1 in UC or SES-CD=3–6), moderate (EMS=2 or SES-CD=7–15) and severe (EMS=3 or SES-CD>15). The primary outcome was the L1-L4 TBS. Secondary outcomes were left total and neck femoral BMD and the L1-L4 region BMD. Results A total of 141 patients were included (115 IBD and 26 HC). Patients with IBD had significantly lower TBS, femoral and L1-L4 BMD and Z-Scores when compared to controls (Figure 1). Endoscopic disease activity was not associated with TBS (Figure 2) or total/neck femur and L1-L4 BMD and Z-scores (p>0.05 for all). When stratifying levels by 25OHD quartiles, patients with 25OHD ≥28 ng/mL (the highest 50th percentile of the study population) had significantly higher TBS Z-scores when compared to those with 25OHD ≤28 ng/mL (0.3 [-0.2 – 1.1] vs -0.1 [-1.1 – 0.5], p=0.002). No associations were seen between TBS Z-scores and use of steroids, gender, type of IBD (UC vs CD), smoking status or when comparing females 50 years or older vs the rest of the group (p>0.05 for all). Moreover, there were no differences in TBS between patients who did or did not engage in resistance exercises (p=0.22) and/or regular aerobic exercises (RAPA ≥6) (p=0.84). Conclusion Patients with IBD present with lower TBS Z-scores when compared to HC and there is no correlation with disease activity. The only variable associated with lower TBS was a 25OHD <28 ng/mL. Further studies looking at the implications of these findings are warranted. FIGURE 1 FIGURE 2

scholarly journals DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Endocrine ◽  
2021 ◽  
Author(s):  
Enisa Shevroja ◽  
Francesco Pio Cafarelli ◽  
Giuseppe Guglielmi ◽  
Didier Hans
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Endocrine Disorders ◽  
Mineral Density ◽  
Increased Risk

AbstractOsteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

scholarly journals Trabecular bone scores in young HIV-infected men: a matched case-control study

2020 ◽  
Author(s):  
Youn Jeong Kim ◽  
Kwi Young Kang ◽  
Juyoung Shin ◽  
Yoonhee Jun ◽  
Sang Il Kim ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Trabecular Microarchitecture ◽  
Cross Sectional ◽  
Young Males ◽  
Matched Case

Abstract Background Screening for osteoporosis with dual-energy X-ray absorptiometry (DXA) is recommended for male HIV-infected patients only above the age of 50. Recently, trabecular bone score (TBS) has been introduced as a novel tool to assess bone microarchitecture using DXA of the lumbar spine. Few studies have reported TBS values in HIV-infected individuals younger than 50 years of age. This study compared TBS values in young males infected with HIV and matched controls, and investigated the associations between TBS and demographic parameters, clinical parameters, and bone mineral density (BMD) scores. Methods A cross-sectional study of BMD and TBS in HIV-infected men (n = 80) aged between 18 and 50 years and age- and sex-matched controls (n = 80) was conducted. Results The proportion of patients with low BMD (Z-score ≤−2) was significantly greater among HIV-infected patients than among matched controls (21.3% [17/80] vs. 8.8% [7/80], p = 0.027). Mean TBS values were significantly lower in HIV-infected patients than in controls (1.41 ± 0.07 vs. 1.45 ± 0.07, p = 0.008). In both groups, TBS values were positively correlated with BMD at the lumbar spine, femoral neck, and total hip (p < 0.001); however, TBS was not correlated with body mass index. In the HIV group, TBS was negatively correlated with the duration of tenofovir disoproxil fumarate(TDF) exposure (p = 0.04). Conclusion Young men infected with HIV had abnormal bone trabecular microarchitecture, as assessed by both TBS and BMD. TBS values were correlated with both BMD and the duration of TDF exposure.

scholarly journals TRABECULAR BONE SCORE – A NON-INVASIVE ANALYTICAL METHOD TO EVALUATE BONE QUALITY BASED ON ROUTINE DUAL-ENERGY ABSORPTIOMETRY. PERSPECTIVES OF ITS USE IN CLINICAL PRACTICE

2016 ◽  
Vol 44 (4) ◽  
pp. 462-476
Author(s):  
T. T. Tsoriev ◽  
Zh. E. Belaya ◽  
G. A. Mel'nichenko
Keyword(s):  
Computed Tomography ◽  
Clinical Practice ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Dual Energy ◽  
Secondary Osteoporosis ◽  
Mineral Density ◽  
Non Invasive ◽  
Physical Measurements

Two-dimensional dual-energy X-ray absorptiometry (DXA, osteodensitometry) is currently considered as the gold standard for diagnosis of osteoporosis. However, despite good operational characteristics, this type of investigation cannot help to assess bone microarchitecture and the degree of its derangement in osteoporosis. Therefore, trabecular bone score (TBS) has been developed as a  non-invasive method of indirect description of bone microarchitecture based on data derived from a  standard DXA of the lumbar spine. Not being a direct mapping of the physical measurements of trabecular microarchitecture, TBS nevertheless shows a positive correlation with quantitative values obtained from micro-computed tomography and high resolution peripheral quantitative computed tomography, i.e. with the bone volume fraction, junction density, trabecular numbers and their disintegration. There is also an association between the ability of the bone tissue to resist stress in experimental studies ex vivo and TBS measurement. Due to TBS, there is a possibility to detect bone microarchitecture impairment even in individuals with normal bone mineral density (BMD), i.e. higher TBS values correlate with improved bone microstructure, whereas a  reduced TBS shows its deterioration. Limitation of TBS use are primarily related to the DXA image quality: image faults caused either by technical reasons or by too low or too high body mass index can lead to an overestimation/underestimation of the index. Assessment of the lumbar TBS has been repeatedly performed in cross-sectional and prospective studies in representative patient samples (mainly postmenopausal women) and significant numbers of healthy subjects, and proved to be a predictor (independent of BMD) of fracture risk. An evaluation of the possibility to use TBS for early diagnosis of secondary osteoporosis (related to various endocrine disorders)  would be of great interest, as BMD, as known from clinical practice, is not always a  reliable measurement of the bone endurance, especially in diabetes, steroid osteoporosis and acromegaly.  The use of TBS along with BMD as a  marker of efficacy of current treatment for secondary osteoporosis is also possible, but it is not yet evidence-based; therefore, research has to be continued.

scholarly journals Trabecular Bone Score Reflects Trabecular Microarchitecture Deterioration and Fragility Fracture in Female Adult Patients Receiving Glucocorticoid Therapy: A Pre-Post Controlled Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Mei-Hua Chuang ◽  
Tzyy-Ling Chuang ◽  
Malcolm Koo ◽  
Yuh-Feng Wang
Keyword(s):  
Trabecular Bone ◽  
Assessment Tool ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Glucocorticoid Therapy ◽  
Analysis Of Covariance ◽  
Controlled Study ◽  
Mineral Density ◽  
Trabecular Microarchitecture

A recently developed diagnostic tool, trabecular bone score (TBS), can provide quality of trabecular microarchitecture based on images obtained from dual-energy X-ray absorptiometry (DXA). Since patients receiving glucocorticoid are at a higher risk of developing secondary osteoporosis, assessment of bone microarchitecture may be used to evaluate risk of fragility fractures of osteoporosis. In this pre-post study of female patients, TBS and fracture risk assessment tool (FRAX) adjusted with TBS (T-FRAX) were evaluated along with bone mineral density (BMD) and FRAX. Medical records of patients with (n=30) and without (n=16) glucocorticoid treatment were retrospectively reviewed. All patients had undergone DXA twice within a 12- to 24-month interval. Analysis of covariance was conducted to compare the outcomes between the two groups of patients, adjusting for age and baseline values. Results showed that a significant lower adjusted mean of TBS (p=0.035) and a significant higher adjusted mean of T-FRAX for major osteoporotic fracture (p=0.006) were observed in the glucocorticoid group. Conversely, no significant differences were observed in the adjusted means for BMD and FRAX. These findings suggested that TBS and T-FRAX could be used as an adjunct in the evaluation of risk of fragility fractures in patients receiving glucocorticoid therapy.

scholarly journals Metabolic Profile and Bone Status in Post-Menopausal Women with Rheumatoid Arthritis: A Monocentric Retrospective Survey

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3168
Author(s):  
Sabrina Paolino ◽  
Elvis Hysa ◽  
Sabrina Atena Stoian ◽  
Emanuele Gotelli ◽  
Andrea Casabella ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Insulin Resistance ◽  
Disease Activity ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Significant Negative Correlation ◽  
Serum Concentrations ◽  
Mineral Density ◽  
Bone Status ◽  
Post Menopausal

Background: Rheumatoid arthritis (RA) and metabolic syndrome (MetS) are chronic conditions that share common inflammatory mechanisms. Both diseases can lead to an impairment of the bone microarchitecture. The aims of our study were to evaluate clinical, metabolic, and bone parameters in RA patients with or without MetS (MetS+, MetS−) and potential correlations between the glico-lipidic profile, RA disease activity, and bone status. Methods: A total of thirty-nine RA female post-menopausal patients were recruited (median age 66.6 ± 10.4, disease duration 3 ± 2.7). Anthropometric data, medical history, and current treatment were recorded along with basal blood tests, bone, and lipid metabolism biomarkers. RA disease activity and insulin resistance were evaluated through standard scores. Quantitative assessment of the bone (bone mineral density—BMD) was performed by dual-energy-X ray absorption (DXA), whereas bone quality was quantified with the trabecular bone score (TBS). Results: No statistically significant differences concerning both BMD and TBS were detected between the MetS+ and MetS− RA patients. However, the MetS+ RA patients exhibited significantly higher disease activity and lower serum 25-hydroxyvitamin D [25(OH)D] concentrations (respectively, p = 0.04 and p = 0.01). In all RA patients, a significant negative correlation emerged between the BMD of the femoral trochanter with plasmatic triglycerides (TG) concentrations (r = −0.38, p = 0.01), whereas the lumbar BMD was positively correlated with the abdominal waist (AW) and fasting glucose (FG) concentrations. On the other hand, the TBS was negatively correlated with insulin concentrations, FG, and RA disease activity (respectively, r = −0.45, p = 0.01, r = −0.40, p = 0.03, r = −0.37, p = 0.04), the last one was further negatively correlated with 25-OHD serum concentrations (r = −0.6, p = 0.0006) and insulin-resistance (r = 0.3, p = 0.04). Conclusions: Bone quantity (BMD) and quality (TBS) do not seem significantly changed among MetS+ and MetS− RA patients; however, among MetS+ patients, both significantly higher disease activity and lower vitamin D serum concentrations were observed. In addition, the significant negative correlations between the alterations of metabolic parameters limited to the TBS in all RA patients might suggest that qualitative bone microarchitecture impairments (TBS) might manifest despite unchanged BMD values.

scholarly journals Spine bone texture assessed by trabecular bone score (TBS) in active and controlled acromegaly: a prospective study

2021 ◽  
Author(s):  
E Sala ◽  
E Malchiodi ◽  
G Carosi ◽  
E Verrua ◽  
E Cairoli ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Trabecular Bone ◽  
Bone Quality ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Normal Density ◽  
Mineral Density ◽  
Gh Secretion ◽  
And Gender ◽  
A Prospective Study

Abstract Purpose Acromegalic patients have an increased vertebral fracture (VFx) risk due to bone quality reduction, independently of bone mineral density (BMD). Aim of the study is to describe bone quality in acromegaly, measured by Trabecular bone score (TBS), a non-invasive index for assessing bone microarchitecture. Methods We collected data of 18 patients (13 F, age 56.2±15 years) newly diagnosed with acromegaly. Thirty-six age-and gender matched healthy controls were also recruited. Pituitary function, bone and calcium-phosphorous metabolism, and BMD at spine and femur and TBS (by dual-X-ray absorptiometry) were assessed in acromegalic patients at diagnosis and 12 months after the achievement of IGF-1 normalization. Results At diagnosis, BMD and the VFx prevalence were comparable between patients and controls (28.3 ± 5.9 vs 27.6 ± 3.7 and 11% vs 8.3%), while TBS was significantly lower in acromegalic patients (1.20±0.13 vs 1.30±0.06; p&lt;0.001) and CTX and osteocalcin were significantly higher compared to controls (707±365.7 vs 371±104.1 pg/ml; p=0.001 and 31.6 ± 15.4 vs 17.0 ± 5.7 ng/ml; p=0.001 respectively). One year after IGF-1 normalization, a significant reduction of bone turnover indexes in the group of acromegalic patients surgically cured (osteocalcin decreased of 61.2%, CTX decreased of 60.3%) compared to the ones controlled by medical therapy was observed (osteocalcin decreased of 39%, CTX decreased of 40.7%; p= 0.01 and p=0.001, respectively). Despite these findings, no TBS or BMD variations were observed. Conclusions Acromegalic patients have an impaired bone quality despite normal density. Achieving normal GH secretion rapidly leads to the normalization of bone turnover.

scholarly journals Effect of Romosozumab on Trabecular Bone Score Compared to Anti-Resorptive Agents in Postmenopausal Women with Osteoporosis

2021 ◽  
Vol 28 (4) ◽  
pp. 317-323
Author(s):  
Chaiho Jeong ◽  
Jinyoung Kim ◽  
Yejee Lim ◽  
Jeonghoon Ha ◽  
Moo Il Kang ◽  
...  
Keyword(s):  
Trabecular Bone ◽  
Postmenopausal Women ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Post Treatment ◽  
Percentage Change ◽  
Mineral Density ◽  
Noticeable Increase ◽  
Observational Cohort ◽  
The Impact

Background: Romosozumab has shown significant improvement in bone mineral density (BMD) in previously reported trials. However, BMD reflects only bone strength and does not offer insight into the bone microarchitecture. The trabecular bone score (TBS) is a non-invasive tool used to assess bone microarchitecture. Several previous studies have evaluated the efficacy of anti-osteoporotic agents using the TBS. However, data regarding the potency of romosozumab based on the TBS is lacking. This retrospective observational cohort study demonstrated the impact of romosozumab use on the TBS.Methods: The primary outcome was the percentage change in the TBS from baseline to post-treatment. Postmenopausal osteoporosis patients were followed up for 6 and 12 months after romosozumab (210 mg monthly, N =10) and denosumab (60 mg every 6 months, N=21) or ibandronate (150 mg monthly, N=24) treatments, respectively. Patients who had previously used osteoporosis medications were included, if any the washout period was sufficient.Results: The percentage change in TBS from baseline to post-treatment was 2.53±2.98% (6 months, N=10; P=0.04), 0.59%±3.26% (12 months, N=21; P=0.48), and -0.45±3.66% (12 months, N=24; P=0.51) in the romosozumab, denosumab, and ibandronate groups, respectively. Romosozumab demonstrated a noticeable increase in TBS, although it did not reach the least significant change (5.8%) in TBS.Conclusions: Romosozumab improved the TBS in postmenopausal women with osteoporosis. TBS may be potentially useful for monitoring romosozumab treatment.

scholarly journals Trabecular bone scores in young HIV-infected men: a matched case-control study

2019 ◽  
Author(s):  
Youn Jeong Kim ◽  
Kwi Young Kang ◽  
Yoonhee Jun ◽  
Sang Il Kim ◽  
Kim Yang Ree
Keyword(s):  
Lumbar Spine ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Trabecular Microarchitecture ◽  
Cross Sectional ◽  
Young Males ◽  
Matched Case

Abstract Background Screening for osteoporosis with dual-energy X-ray absorptiometry (DXA) is recommended for male HIV-infected patients only above the age of 50. Recently, trabecular bone score (TBS) has been introduced as a novel tool to assess bone microarchitecture using DXA of the lumbar spine. Few studies have reported TBS values in HIV-infected individuals younger than 50 years of age. This study compared TBS values in young males infected with HIV and matched controls, and investigated the associations between TBS and demographic parameters, clinical parameters, and bone mineral density (BMD) scores. Methods A cross-sectional study of BMD and TBS in HIV-infected men (n = 80) aged between 18 and 50 years and age- and sex-matched controls (n = 80) was conducted. Results The proportion of patients with low BMD (Z-score ≤−2) was significantly greater among HIV-infected patients than among matched controls (21.3% [17/80] vs. 8.8% [7/80], p = 0.027). Mean TBS values were significantly lower in HIV-infected patients than in controls (1.41 ± 0.07 vs. 1.45 ± 0.07, p = 0.008). In both groups, TBS values were positively correlated with BMD at the lumbar spine, femoral neck, and total hip (p < 0.001); however, TBS was not correlated with body mass index. In the HIV group, TBS was negatively correlated with the duration of tenofovir disoproxil fumarate(TDF) exposure (p = 0.04). Conclusion Young men infected with HIV had abnormal bone trabecular microarchitecture, as assessed by both TBS and BMD. TBS values were correlated with both BMD and the duration of TDF exposure.

Trabecular Bone Score in Female Patients with Systemic Sclerosis: Comparison with Rheumatoid Arthritis and Influence of Glucocorticoid Exposure

2014 ◽  
Vol 42 (2) ◽  
pp. 228-235 ◽  
Author(s):  
Eugénie Koumakis ◽  
Jérôme Avouac ◽  
Renaud Winzenrieth ◽  
Emese Toth ◽  
Judith Payet ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Sclerosis ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Bone Involvement ◽  
High Risk Population ◽  
Mineral Density ◽  
Female Patients ◽  
Increased Risk

Objective.Systemic sclerosis (SSc) is associated with an increased risk of osteoporosis and fractures. To date, the etiology of bone loss in SSc is unclear. Trabecular bone score (TBS) provides an indirect measurement of bone microarchitecture, independent of areal bone mineral density (aBMD). The aims were to assess bone involvement in SSc using TBS in comparison with a “high-risk” population with rheumatoid arthritis (RA) and controls, and to investigate the determinants of a low TBS.Methods.This was a cross-sectional study of 65 women with SSc, 138 age-matched female patients with RA, and 227 age-matched female controls. Spine and hip aBMD were assessed using dual-energy X-ray absorptiometry. TBS was calculated from the anteroposterior image of the spine aBMD.Results.TBS was significantly lower in SSc compared to controls (p < 0.0001) and did not differ from RA (p = 0.128), despite lower cumulative and daily glucocorticoid (GC) dose (p < 0.0001). Further, patients with SSc receiving GC ≥ 5 mg/day had a significantly lower TBS than those receiving GC < 5 mg/day (p = 0.001). Multivariate analysis revealed that a low TBS was independently associated with daily GC dose (OR 5.6, 95% CI 1.7–19.2) and a T score ≤ −2.5 SD (OR 5.0, 95% CI 1.5–7.0) in SSc. No association between GC and TBS was found in RA.Conclusion.Our results support the development of a combined approach using both TBS and aBMD for the assessment of bone microarchitecture in inflammatory rheumatic diseases. Our study showed that SSc-related bone involvement is characterized by an impairment in bone quality in addition to reduced bone quantity, and highlights that TBS can identify the negative effect of GC on bone microarchitecture.

scholarly journals What Role Does Trabecular Bone Score Play in Chronic Inflammatory Rheumatic Diseases?

2020 ◽  
Vol 7 ◽  
Author(s):  
Barbara Ruaro ◽  
Andrea Casabella ◽  
Luigi Molfetta ◽  
Francesco Salton ◽  
Paola Confalonieri ◽  
...  
Keyword(s):  
Trabecular Bone ◽  
Rheumatic Diseases ◽  
Inflammatory Diseases ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Clinical Aspects ◽  
Inflammatory Rheumatic Diseases ◽  
Mineral Density ◽  
Pixel Intensity ◽  
Chronic Inflammatory Rheumatic Diseases

Patients suffering from rheumatic inflammatory diseases, e.g., systemic sclerosis, rheumatoid arthritis, and ankylosing spondylitis, are at risk of low bone mass. Dual-energy X-ray Absorptiometry (DXA) is the traditional radiological measurement technique for bone mineral density (BMD). The recently developed trabecular bone score (TBS) enhances the skeletal information provided by standard BMD. It re-analyzes the spatial dynamics of pixel intensity changes in lumbar spine DXA images, defining a quantitative index, characterizing trabecular bone microarchitecture. It has been demonstrated that low TBS values are associated with an increased incidence of fractures in patients with rheumatic diseases. These methods used together for bone damage evaluation can be of value to identify individuals who will potentially fracture. The main scientific literature on the clinical aspects of osteoporosis, including the use of TBS in evaluating this pathology, are herein reported aimed at shedding light on the role trabecular bone score plays in chronic inflammatory rheumatic diseases.

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