Endocrine Abstracts

Background: Osteoporosis frequently occurs in elderly people and is commonly associated with fall and fractures which leads the increase of morbidity and mortality. Therefore, precise prediction of osteoporotic fracture is important in clinical setting. The objective of this study was to investigate the association between baseline compression fracture and trabecular bone score (TBS) and was to assess the ability of TBS to predict vertebral fragility fracture and changes of volumetric BMD (vBMD) in postmenopausal women.

Materials and methods: We enrolled 270 postmenopausal women aged over 46 who visited our hospital for a health check-up between Sep, 2013 and Sep 2017. TBS was calculated from dual energy X-ray absorptiometry and vBMD was generated from central quantitative computed tomography (cQCT). Both baseline and follow-up X-ray images were reviewed for the evaluation of thoracolumbar vertebral compression fracture which were defined according to the Genant criteria.

Result: At baseline, 76 (28.1 %) compression fractures were identified in 270 participants and the additional or progressive fractures occurred in 21 participants (7.8 %) for the median 19.5 month of the follow-up period. The median TBS was significantly higher in participants without vertebral fracture (median: 1.326, interquartile range [IQR]: 1.264–1.372) compared with that of those with vertebral fracture (median: 1.246, IQR: 0.169–1.308, P < 0.001). During the follow-up, the deteriorated TBS value (≤ 1.31) were significantly associated with osteoporotic change of BMD assessed by cQCT using Kaplan-Meier analysis (Hazard ratio [HR]; 2.423, confidence interval [CI]: 1.708–3.438, P < 0.001). Lower TBS (Hazard ratio [HR]; 2.505, confidence interval [CI]: 1.062– 5.911, P = 0.036) was also revealed as a significant risk factor for the future vertebral fragility fracture.

Conclusion: The patients who had the deteriorated status of TBS showed more frequent predisposing compression fracture. In addition, it was suggested that TBS has the potential to predict future vertebral fractures in patients.