Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study.

Détails

ID Serval
serval:BIB_367F3898EB53
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study.
Périodique
Osteoporosis International
Auteur(s)
Boutroy S., Hans D., Sornay-Rendu E., Vilayphiou N., Winzenrieth R., Chapurlat R.
ISSN
1433-2965 (Electronic)
ISSN-L
0937-941X
Statut éditorial
Publié
Date de publication
2013
Peer-reviewed
Oui
Volume
24
Numéro
1
Pages
77-85
Langue
anglais
Notes
Publication types: Journal Article
Résumé
The use of areal bone mineral density (aBMD) for fracture prediction may be enhanced by considering bone microarchitectural deterioration. Trabecular bone score (TBS) helped in redefining a significant subset of non-osteoporotic women as a higher risk group.
INTRODUCTION: TBS is an index of bone microarchitecture. Our goal was to assess the ability of TBS to predict incident fracture.
METHODS: TBS was assessed in 560 postmenopausal women from the Os des Femmes de Lyon cohort, who had a lumbar spine (LS) DXA scan (QDR 4500A, Hologic) between years 2000 and 2001. During a mean follow-up of 7.8 ± 1.3 years, 94 women sustained 112 fragility fractures.
RESULTS: At the time of baseline DXA scan, women with incident fracture were significantly older (70 ± 9 vs. 65 ± 8 years) and had a lower LS_aBMD and LS_TBS (both -0.4SD, p < 0.001) than women without fracture. The magnitude of fracture prediction was similar for LS_aBMD and LS_TBS (odds ratio [95 % confidence interval] = 1.4 [1.2;1.7] and 1.6 [1.2;2.0]). After adjustment for age and prevalent fracture, LS_TBS remained predictive of an increased risk of fracture. Yet, its addition to age, prevalent fracture, and LS_aBMD did not reach the level of significance to improve the fracture prediction. When using the WHO classification, 39 % of fractures occurred in osteoporotic women, 46 % in osteopenic women, and 15 % in women with T-score > -1. Thirty-seven percent of fractures occurred in the lowest quartile of LS_TBS, regardless of BMD. Moreover, 35 % of fractures that occurred in osteopenic women were classified below this LS_TBS threshold.
CONCLUSION: In conclusion, LS_aBMD and LS_TBS predicted fractures equally well. In our cohort, the addition of LS_TBS to age and LS_aBMD added only limited information on fracture risk prediction. However, using the lowest quartile of LS_TBS helped in redefining a significant subset of non-osteoporotic women as a higher risk group which is important for patient management.
Pubmed
Web of science
Création de la notice
18/01/2013 11:18
Dernière modification de la notice
20/08/2019 14:24
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