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KMID : 1120320170030000088
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Osteoporosis and Sarcopenia
2017 Volume.3 No. 0 p.88 ~ p.88
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Trabecular bone score (Tbs) and fracture risk prediction in Asian type 2s diabetic subject
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Yeap S.S.
Lee L.F.
Feiza K.
Hew C.K.T.
Lim H.K.
Lim J.
Hew F.L.
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Abstract
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Introduction: Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk but at greater bone mineral density (BMD). The trabecular bone score (TBS) is a novel gray-scale analysis of BMD as obtained with dual-energy X-ray absorptiometry (DXA) which gives information on microarchitecture and bone quality. This study compared the performance of TBS, BMD, and original and TBS-adjusted FRAX scores in T2DM patients compared with their non-diabetic (nonDM) control.
Materials & methods: This retrospective study enrolled consecutive patients who had a BMD measured in the facility between Dec 2008 and June 2017. The subjects were divided into T2DM and nonDM and compared. All those with conditions that could affect bone or calcium metabolism, or on medications that could affect bone were excluded. BMD was measured using DXA. TBS was obtained using the TBS iNsight software program (Med-Imaps, Pessac, France) with BMD DXA images.
Results: There were 56 T2DM and 56 nonDM subjects. Median duration of T2DM was 10.0 years (interquartile range [IQR] 13.0). Table 1 shows the characteristics of the 2 groups. There was no difference in BMD at all sites between the 2 groups. TBS correlated with age (p=0.009). TBS values were lower in those who had had a low-trauma fracture compared to those who had not (median 1.210 vs 1.327, p=0.001). Interestingly, lumbar spine BMD was not significantly different between the fracture/no fracture groups but both femoral neck and total hip BMD was significantly lower in the fracture group (p<0.0001 for both). Calculated FRAX scores were significantly different between T2DM and nonDM patients even though previous fractures were not significantly different between the 2 groups (p=0.303).
Discussion: Previous studies have found TBS scores to be lower in subjects with DM [1] which is in contrast to this study. There were differences in the FRAX score calculated with and without TBS but the differences were small and may not be clinically significant.
Conclusion: There was no difference in the TBS score between this T2DM and nonDM population. However, TBS correlated with age, and was lower in subjects who had a prior fracture.
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