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Osteoporos Int. 2019 Nov 21. doi: 10.1007/s00198-019-05215-z. [Epub ahead of print]

Determinants of trabecular bone score and prevalent vertebral fractures in women with fragility fractures: a cross-sectional sub-study of NoFRACT.

Author information

1
Department of Rheumatology, Vestre Viken Hospital Trust, Drammen Hospital, Box 800, 3004, Drammen, Norway. tove.tveitan.borgen@vestreviken.no.
2
Department of Clinical Medicine, University of Oslo, Oslo, Norway. tove.tveitan.borgen@vestreviken.no.
3
Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.
4
Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway.
5
Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
6
Department of Orthopedic Surgery, University Hospital of North Norway, Tromsø, Norway.
7
Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
8
Department of Rheumatology, Vestre Viken Hospital Trust, Drammen Hospital, Box 800, 3004, Drammen, Norway.
9
Department of Orthopedic Surgery, Vestre Viken Hospital Trust, Drammen Hospital, Drammen, Norway.
10
Department of Orthopedic Surgery, Vestre Viken Hospital Trust, Bærum Hospital, Bærum, Norway.
11
Bergen group of Epidemiology and Biomarkers in Rheumatic Disease, Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.
12
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
13
Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway.
14
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
15
Department of Orthopedic Surgery, St. Olavs University Hospital, Trondheim, Norway.
16
Department of Orthopedic Surgery, Møre and Romsdal Hospital Trust, Molde Hospital, Molde, Norway.
17
Department of Community Medicine and Global health, Institute of Health and Society, University of Oslo, Oslo, Norway.
18
Department of Clinical Medicine, University of Oslo, Oslo, Norway.
19
Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.

Abstract

Determinants of trabecular bone score (TBS) and vertebral fractures assessed semiquantitatively (SQ1-SQ3) were studied in 496 women with fragility fractures. TBS was associated with age, parental hip fracture, alcohol intake and BMD, not SQ1-SQ3 fractures. SQ1-SQ3 fractures were associated with age, prior fractures, and lumbar spine BMD, but not TBS.

INTRODUCTION:

Trabecular bone score (TBS) and vertebral fractures assessed by semiquantitative method (SQ1-SQ3) seem to reflect different aspects of bone strength. We therefore sought to explore the determinants of and the associations between TBS and SQ1-SQ3 fractures.

METHODS:

This cross-sectional sub-study of the Norwegian Capture the Fracture Initiative included 496 women aged ≥ 50 years with fragility fractures. All responded to a questionnaire about risk factors for fracture, had bone mineral density (BMD) of femoral neck and/or lumbar spine assessed, TBS calculated, and 423 had SQ1-SQ3 fracture assessed.

RESULTS:

Mean (SD) age was 65.6 years (8.6), mean TBS 1.27 (0.10), and 33.3% exhibited SQ1-SQ3 fractures. In multiple variable analysis, higher age (βper SD = - 0.26, 95% CI: - 0.36,- 0.15), parental hip fracture (β = - 0.29, 95% CI: - 0.54,- 0.05), and daily alcohol intake (β = - 0.43, 95% CI - 0.79, - 0.08) were associated with lower TBS. Higher BMD of femoral neck (βper SD = 0.34, 95% CI 0.25-0.43) and lumbar spine (βper SD = 0.40, 95% CI 0.31-0.48) were associated with higher TBS. In multivariable logistic regression analyses, age (ORper SD = 1.94, 95% CI 1.51-2.46) and prior fragility fractures (OR = 1.71, 95% CI 1.09-2.71) were positively associated with SQ1-SQ3 fractures, while lumbar spine BMD (ORper SD = 0.75 95% CI 0.60-0.95) was negatively associated with SQ1-SQ3 fractures. No association between TBS and SQ1-SQ3 fractures was found.

CONCLUSION:

Since TBS and SQ1-SQ3 fractures were not associated, they may act as independent risk factors, justifying the use of both in post-fracture risk assessment.

KEYWORDS:

Bone mineral density; Fracture risk; Osteoporosis; Trabecular bone score; Vertebral fracture assessment; Vertebral fractures

PMID:
31754755
DOI:
10.1007/s00198-019-05215-z

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