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Contributions of Clinical and Technical Factors to Longitudinal Change in Trabecular Bone Score and Bone Density: A Registry-Based Individual-Level Analysis

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Název: Contributions of Clinical and Technical Factors to Longitudinal Change in Trabecular Bone Score and Bone Density: A Registry-Based Individual-Level Analysis
Autoři: William D Leslie, Heenam Goel, Neil Binkley, Eugene V McCloskey, Didier Hans
Zdroj: Journal of bone and mineral research, vol. 38, no. 4, pp. 512-521
Informace o vydavateli: Oxford University Press (OUP), 2020.
Rok vydání: 2020
Témata: Adult, 03 medical and health sciences, Absorptiometry, Photon, Lumbar Vertebrae, 0302 clinical medicine, Bone Density Conservation Agents, Bone Density, Humans, Bone Density/physiology, Cancellous Bone/diagnostic imaging, Osteoporotic Fractures/drug therapy, Osteoporosis/diagnostic imaging, Osteoporosis/drug therapy, Osteoporosis/complications, Absorptiometry, Photon/adverse effects, Absorptiometry, Photon/methods, Bone Density Conservation Agents/therapeutic use, Lumbar Vertebrae/diagnostic imaging, Registries, BONE MINERAL DENSITY, DXA, OSTEOPOROSIS, TRABECULAR BONE SCORE, Cancellous Bone, Osteoporosis, Osteoporotic Fractures
Popis: Lumbar spine trabecular bone score (TBS), a gray-level texture measure derived from spine dual-energy X-ray absorptiometry (DXA) images, is a bone mineral density (BMD)-independent risk factor for fracture. An unresolved question is whether TBS is sufficiently responsive to change over time or in response to widely used osteoporosis therapy at the individual level to serve as a useful biomarker. Using the Manitoba DXA Registry, we identified 11,643 individuals age 40 years and older with two fan-beam DXA scans performed on the same instrument within 5 years (mean interval 3.2 years), of whom 6985 (60.0%) received antiresorptive osteoporosis medication (majority oral bisphosphonate) between the scans. We examined factors that were associated with a change in lumbar spine TBS, lumbar spine BMD, and total hip BMD exceeding the 95% least significant change (LSC). Change exceeding the LSC was identified in 23.0% (9.3% increase, 13.8% decrease) of lumbar spine TBS, 38.2% (22.1% increase, 16.1% decrease) lumbar spine BMD, and 42.5% (17.6% increase, 24.9% decrease) total hip BMD measurement pairs. From regression models, the variables most strongly associated with significant change in TBS (decreasing order) were tissue thickness change, acquisition mode change, weight change, and spine percent fat change. Consistent with the insensitivity of TBS to oral antiresorptive therapies, use of these agents showed very little effect on TBS change. In contrast, for both spine BMD change and total hip BMD change, osteoporosis medication use was the most significant variable, whereas tissue thickness change, acquisition mode change, and weight change had relatively weak effects. In summary, change in spine TBS using the present algorithm appears to be strongly affected by technical factors. This suggests a limited role, if any, for using TBS change in untreated individuals or for monitoring response to antiresorptive treatment in routine clinical practice with the current version of the TBS algorithm. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Druh dokumentu: Article
Popis souboru: application/pdf
Jazyk: English
ISSN: 1523-4681
0884-0431
DOI: 10.1002/jbmr.4774
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/36655775
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_E2212272069C3
https://serval.unil.ch/notice/serval:BIB_E2212272069C
https://serval.unil.ch/resource/serval:BIB_E2212272069C.P001/REF.pdf
Rights: CC BY NC ND
Přístupové číslo: edsair.doi.dedup.....f6044203bcb6320d70e28c45646628f3
Databáze: OpenAIRE
Popis
Abstrakt:Lumbar spine trabecular bone score (TBS), a gray-level texture measure derived from spine dual-energy X-ray absorptiometry (DXA) images, is a bone mineral density (BMD)-independent risk factor for fracture. An unresolved question is whether TBS is sufficiently responsive to change over time or in response to widely used osteoporosis therapy at the individual level to serve as a useful biomarker. Using the Manitoba DXA Registry, we identified 11,643 individuals age 40 years and older with two fan-beam DXA scans performed on the same instrument within 5 years (mean interval 3.2 years), of whom 6985 (60.0%) received antiresorptive osteoporosis medication (majority oral bisphosphonate) between the scans. We examined factors that were associated with a change in lumbar spine TBS, lumbar spine BMD, and total hip BMD exceeding the 95% least significant change (LSC). Change exceeding the LSC was identified in 23.0% (9.3% increase, 13.8% decrease) of lumbar spine TBS, 38.2% (22.1% increase, 16.1% decrease) lumbar spine BMD, and 42.5% (17.6% increase, 24.9% decrease) total hip BMD measurement pairs. From regression models, the variables most strongly associated with significant change in TBS (decreasing order) were tissue thickness change, acquisition mode change, weight change, and spine percent fat change. Consistent with the insensitivity of TBS to oral antiresorptive therapies, use of these agents showed very little effect on TBS change. In contrast, for both spine BMD change and total hip BMD change, osteoporosis medication use was the most significant variable, whereas tissue thickness change, acquisition mode change, and weight change had relatively weak effects. In summary, change in spine TBS using the present algorithm appears to be strongly affected by technical factors. This suggests a limited role, if any, for using TBS change in untreated individuals or for monitoring response to antiresorptive treatment in routine clinical practice with the current version of the TBS algorithm. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
ISSN:15234681
08840431
DOI:10.1002/jbmr.4774