KMID : 1144220220280030112
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Journal of Menopausal Medicine 2022 Volume.28 No. 3 p.112 ~ p.120
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Trabecular Bone Score as a Risk Factor of Major Osteoporotic Fracture in Postmenopausal Women: The First Study in Thailand
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Therdyothin Atiporn
Amphansap Tanawat
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Abstract
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Objectives: To compare the trabecular bone score (TBS) between Thai postmenopausal women with and without major osteoporotic fracture, and to determine whether TBS is associated with fracture risk.
Methods: All postmenopausal women sent for dual-energy X-ray absorptiometry (DXA) at the Police General Hospital were retrospectively recruited. The hospital¡¯s online database and radiographs were reviewed to collect information on underlying disease, medication, previous fractures, bone mineral density, and trabecular bone score. Patients with anti-osteoporotic medication use, skeletal malignancy, fracture from high-energy trauma, and uninterpretable DXA images were excluded.
Results: A total of 407 Thai postmenopausal women were enrolled. They were divided into 292 women without fractures and 115 women with major osteoporotic fractures. The fracture group was older (73.36 ¡¾ 9.95 vs. 66.00 ¡¾ 8.58, P < 0.001) and had lower serum 25-hydroxyvitamin D levels (23.28 ¡¾ 9.09 vs. 26.44 ¡¾ 9.20, P = 0.023). The mean TBS was lower in the fracture group, compared to the non-fracture group (1.244 ¡¾ 0.101 vs. 1.272 ¡¾ 0.099, P = 0.011). The subgroup analysis resulted in noticeably lower TBS in spine fracture, but not other fracture sites. The odds ratio of fracture was 1.355 (P = 0.013) for a decrease in one standard deviation of TBS.
Conclusions: TBS was significantly lower in postmenopausal women having fractures with an odd ratio of 1.355 (P = 0.013) per SD decrease in TBS. Categorizing by fracture sites, TBS was only found to be noticeably lower in the lumbar spine despite similar lumbar spine bone mineral density.
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KEYWORD
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Bone quality, Fracture risk, Fragility fracture, Osteoporosis, Trabecular bone score
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