Accuracy of Trabecular Bone Score to Assess Fragility Fracture Risk in T1D

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To assess fragility fracture risk, average BMD was calculated at lumbar spine, femoral neck, and total hip.
To assess fragility fracture risk, average BMD was calculated at lumbar spine, femoral neck, and total hip.
First Report from Clinical Osteoporosis 2017:
A Joint Conference of the NOF & ISCD


Trabecular bone score (TBS) may be influenced by body mass index (BMI) in patients with type 1 diabetes, according to research presented at Clinical Osteoporosis 2017: A Joint Symposium of the National Osteoporosis Foundation (NOF) and the International Society of Clinical Den (ISCD) in Orlando, Florida, April 20-22.

Researchers sought to examine TBS in a group of adults with type 1 diabetes to determine the relationship between diabetes and bone mineral density (BMD). A total of 43 patients were prospectively recruited (mean age, 34.9; 70% women; 88% white) to participate.

 

Of the participants, 44% were diagnosed with type 1 diabetes before the onset of puberty and the mean disease duration was 16.7 years. Nearly half of all participants had a history of fracture, 33% of which were fragility fractures.

Average BMD was calculated at lumbar spine, femoral neck, and total hip; measurements were 1.17 g/cm2, 0.94 g/cm2, and 0.97 g/cm2, respectively. Average TBS was 1.47, and researchers noted a modest correlation between TBS and BMD (0.41, 0.492, and 0.472 at lumbar spine, femoral neck, and total hip, respectively; P =.006, .001, and .002, respectively).

TBS was not correlated with age, gender, hemoglobin A1c (HbA1c), diabetes onset, or diabetes duration. An inverse association between TBS and microvascular complications, which lacked statistical significance, was noted.

Fragility fracture risk increased with older age (odds ratio [OR]: 1.077; P =.014) and decreased with higher BMD (OR: 0.001 and 0.002 for femoral neck and total hip; P = .029 and .036, respectively).

“TBS correlated with BMD at all sites, and appears to be influenced by BMI,” the researchers concluded. “A larger study in older patients with longer duration of [type 1 diabetes] is required to better assess the utility of TBS in this patient population.”

Reference

Gilmour J, Colquhoun A, Wu W, Kim S. Type 1 diabetes and bone microarchitecture assessment with trabecular bone score (TBS): a descriptive study. Presented at: Clinical Osteoporosis 2017: A Joint Symposium of NOF & ISCD. April 20-22, 2017; Orlando, Florida.

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