[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
:: Volume 32, Issue 4 (winter 2022) ::
MEDICAL SCIENCES 2022, 32(4): 409-418 Back to browse issues page
Comparison of FRAX and FRAX-TBS in predicting osteoprotic fracture risk in postmenopausal women
Roxana Peysepar1 , Laleh Ghanei 2, Sahar Ghareh3, Shahla Abolghasemi4, Alipasha Meysamie5, Parima Hoseini6
1- Internal Medicine Specialist, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
2- Endocrinologist, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran , Iran , Ghanei.laleh@gmail.com
3- Endocrinologist,, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran , Iran
4- Rheumatologist, Department of Internal medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran , Iran
5- Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
6- Depratment of Radiation Application, Shahid Beheshti University, Tehran, Iran
Abstract:   (305 Views)
Background: Trabecular Bone Score (TBS) is an index of bone microarchitecture that provides additional skeletal information to areal Bone Mineral Density (aBMD). Recently TBS data has been used to optimize the Fracture Risk Assessment Tool (FRAX) predictive value. Aim of this study was to evaluate the clinical value of TBS on FRAX algorithm.
Materials and methods: 545 postmenopausal women (mean age 61.64±7.94 years) indicated for bone densitometry were tested for aBMD and TBS. 96 women was diagnosed as osteoporotic and 140 osteopenic women were identified. FRAX and TBS adjusted FRAX (FRAX-TBS) were calculated and compared.
Results: Mean score of TBS was 1.29± 0.09. A strong positive correlation was observed between FRAX and FRAX-TBS in predicting the risk of major osteoporotic fracture (r=0.836, p< 0.0001), and hip fracture (r=0.922, p< 0.0001). aBMD adjusted FRAX and FRAX-TBS was assessed in all sample and the osteopenic group. There was significant difference in number of cases need to treatment based on FRAX and FRAX-TBS.
Conclusion: This study showed significant clinical benefit for TBS and adding TBS data to FRAX for decision making in the treatment.
Keywords: Osteoporosis, TBS, aBMD, FRAX
Full-Text [PDF 550 kb]   (115 Downloads)    
Semi-pilot: Survey/Cross Sectional/Descriptive | Subject: Metabolism and Endocrinology
Received: 2022/01/3 | Accepted: 2022/02/27 | Published: 2022/12/31
1. Riggs BL, Melton LJ 3rd. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 1995;17:505S-511S. [DOI:10.1016/8756-3282(95)00258-4]
2. Johnell O, Hertzman P. Health Evidence Network report: What evidence is there for the prevention and screening of osteoporosis. Copenhagen; WHO Regional Office for Europe; 2006.
3. Melton LJ 3rd. Hip fractures: a worldwide problem today and tomorrow. Bone 1993;14:S1-8. [DOI:10.1016/8756-3282(93)90341-7]
4. Holroyd C, Cooper C, Dennison E. Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab 2008;22:671-85. [DOI:10.1016/j.beem.2008.06.001]
5. Irani AD, Poorolajal J, Khalilian A, Esmailnasab N, Cheraghi Z. Prevalence of osteoporosis in Iran: A meta-analysis. J Res Med Sci 2013;18:759-66.
6. Harvey NC, Glüer CC, Binkley N, McCloskey EV, Brandi ML, Cooper C, et al. Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice. Bone 2015;78:216-24. [DOI:10.1016/j.bone.2015.05.016]
7. Hui SL, Slemenda CW, Johnston CC Jr. Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 1988;81:1804-9. [DOI:10.1172/JCI113523]
8. Kanis JA, Johansson H, Oden A, Johnell O, De Laet C, Eisman JA, et al. A family history of fracture and fracture risk: a meta-analysis. Bone 2004;35:1029-37. [DOI:10.1016/j.bone.2004.06.017]
9. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 1994;4:368-81. [DOI:10.1007/BF01622200]
10. Winzenrieth R, Dufour R, Pothuaud L, Hans D. A retrospective case-control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture. Calcif Tissue Int 2010 ;86:104-9. [DOI:10.1007/s00223-009-9322-y]
11. Choi YJ, Ock SY, Chung YS. Trabecular Bone Score (TBS) and TBS-Adjusted Fracture Risk Assessment Tool are Potential Supplementary Tools for the Discrimination of Morphometric Vertebral Fractures in Postmenopausal Women With Type 2 Diabetes. J Clin Densitom 2016 ;19:507-514. [DOI:10.1016/j.jocd.2016.04.001]
12. Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005;20:1185-94. [DOI:10.1359/JBMR.050304]
13. Siris ES, Baim S, Nattiv A. Primary care use of FRAX: absolute fracture risk assessment in postmenopausal women and older men. Postgrad Med 2010;122:82-90. [DOI:10.3810/pgm.2010.01.2102]
14. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 1994;4:368-81. [DOI:10.1007/BF01622200]
15. Hans D, Goertzen AL, Krieg MA, Leslie WD. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res 2011;26:2762-9. [DOI:10.1002/jbmr.499]
16. McCloskey EV, Odén A, Harvey NC, Leslie WD, Hans D, Johansson H, et al. A Meta-Analysis of Trabecular Bone Score in Fracture Risk Prediction and Its Relationship to FRAX. J Bone Miner Res 2016;31:940-8. [DOI:10.1002/jbmr.2734]
17. Boutroy S, Hans D, Sornay-Rendu E, Vilayphiou N, Winzenrieth R, Chapurlat R. Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study. Osteoporos Int 2013;24:77-85. [DOI:10.1007/s00198-012-2188-2]
18. Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N. A reference standard for the description of osteoporosis. Bone 2008;42:467-75. [DOI:10.1016/j.bone.2007.11.001]
19. Miller PD, Siris ES, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, et al. Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res 2002;17:2222-30. [DOI:10.1359/jbmr.2002.17.12.2222]
20. WHO. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group (meeting held in Rome from 22 to 25 June 1992)‎‎‎. Geneva: World Health Organization; 1994.
21. Albrand G, Munoz F, Sornay-Rendu E, DuBoeuf F, Delmas PD. Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: the OFELY study. Bone 2003;32:78-85. [DOI:10.1016/S8756-3282(02)00919-5]
22. Díez-Pérez A, González-Macías J, Marín F, Abizanda M, Alvarez R, Gimeno A, et al; Ecografía Osea en Atención Primaria study investigators. Prediction of absolute risk of non-spinal fractures using clinical risk factors and heel quantitative ultrasound. Osteoporos Int 2007;18:629-39. [DOI:10.1007/s00198-006-0297-5]
23. Cohen A, Dempster DW, Müller R, Guo XE, Nickolas TL, Liu XS, et al. Assessment of trabecular and cortical architecture and mechanical competence of bone by high-resolution peripheral computed tomography: comparison with transiliac bone biopsy. Osteoporos Int 2010;21:263-73. [DOI:10.1007/s00198-009-0945-7]
24. Graeff C, Marin F, Petto H, Kayser O, Reisinger A, Peña J, et al. High resolution quantitative computed tomography-based assessment of trabecular microstructure and strength estimates by finite-element analysis of the spine, but not DXA, reflects vertebral fracture status in men with glucocorticoid-induced osteoporosis. Bone 2013;52:568-77. [DOI:10.1016/j.bone.2012.10.036]
25. Diez-Perez A, Güerri R, Nogues X, Cáceres E, Peña MJ, Mellibovsky L, et al. Microindentation for in vivo measurement of bone tissue mechanical properties in humans. J Bone Miner Res 2010;25:1877-85. [DOI:10.1002/jbmr.73]
26. Silva BC, Leslie WD, Resch H, Lamy O, Lesnyak O, Binkley N, et al. Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 2014;29:518-30. [DOI:10.1002/jbmr.2176]
27. Winzenrieth R, Michelet F, Hans D. Three-dimensional (3D) microarchitecture correlations with 2D projection image gray-level variations assessed by trabecular bone score using high-resolution computed tomographic acquisitions: effects of resolution and noise. J Clin Densitom 2013;16:287-296. [DOI:10.1016/j.jocd.2012.05.001]
28. Simonelli C, Leib E, Mossman N, Winzenrieth R, Hans D, McClung M. Creation of an age-adjusted, dual-energy x-ray absorptiometry-derived trabecular bone score curve for the lumbar spine in non-Hispanic US White women. J Clin Densitom 2014;17:314-9. [DOI:10.1016/j.jocd.2013.09.002]
29. Leslie WD, Caetano PA, MacWilliam LR, Finlayson GS. Construction and validation of a population-based bone densitometry database. J Clin Densit 2005;8: 25-30. [DOI:10.1385/JCD:8:1:025]
30. Leslie WD, Anderson WA, Metge CJ, Manness LJ. Clinical risk factors for fracture in postmenopausal Canadian women: a population-based prevalence study. Bone 2007;40:99. [DOI:10.1016/j.bone.2006.11.008]
31. Hans D, Barthe N, Boutroy S, Pothuaud L, Winzenrieth R, Krieg MA. Correlations between trabecular bone score, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J Clin Densitom 2011;14:302-12. [DOI:10.1016/j.jocd.2011.05.005]
32. Kalder M, Hans D, Kyvernitakis I, Lamy O, Bauer M, Hadji P. Effects of Exemestane and Tamoxifen treatment on bone texture analysis assessed by TBS in comparison with bone mineral density assessed by DXA in women with breast cancer. J Clin Densitom 2014;17:66-71. [DOI:10.1016/j.jocd.2013.03.003]
33. Krieg MA, Aubry-Rozier B, Hans D, Leslie WD; Manitoba Bone Density Program. Effects of anti-resorptive agents on trabecular bone score (TBS) in older women. Osteoporos Int 2013;24:1073-8. [DOI:10.1007/s00198-012-2155-y]
34. Popp AW, Meer S, Krieg MA, Perrelet R, Hans D, Lippuner K. Bone mineral density (BMD) and vertebral trabecular bone score (TBS) for the identification of elderly women at high risk for fracture: the SEMOF cohort study. Eur Spine J 2016;25:3432-3438. [DOI:10.1007/s00586-015-4035-6]
35. Popp AW, Guler S, Lamy O, Senn C, Buffat H, Perrelet R, et al. Effects of zoledronate versus placebo on spine bone mineral density and microarchitecture assessed by the trabecular bone score in postmenopausal women with osteoporosis: a three-year study. J Bone Miner Res 2013;28:449-54. [DOI:10.1002/jbmr.1775]
36. Iki M, Tamaki J, Kadowaki E, Sato Y, Dongmei N, Winzenrieth R, et al. Trabecular bone score (TBS) predicts vertebral fractures in Japanese women over 10 years independently of bone density and prevalent vertebral deformity: the Japanese Population-Based Osteoporosis (JPOS) cohort study. J Bone Miner Res 2014;29:399-407. [DOI:10.1002/jbmr.2048]
37. Briot K, Paternotte S, Kolta S, Eastell R, Reid DM, Felsenberg D, et al. Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women: the OPUS study. Bone 2013;57:232-6. [DOI:10.1016/j.bone.2013.07.040]
38. Leslie WD, Aubry-Rozier B, Lix LM, Morin SN, Majumdar SR, Hans D. Spine bone texture assessed by trabecular bone score (TBS) predicts osteoporotic fractures in men: the Manitoba Bone Density Program. Bone 2014;67:10-4. [DOI:10.1016/j.bone.2014.06.034]
39. Kanis JA, Oden A, Johansson H, McCloskey E. Pitfalls in the external validation of FRAX. Osteoporosis Int 2012; 23:423-431. [DOI:10.1007/s00198-011-1846-0]
40. McCloskey EV, Odén A, Harvey NC, Leslie WD, Hans D, Johansson H, et al. Adjusting fracture probability by trabecular bone score. Calcif Tissue Int 2015;96:500-9. [DOI:10.1007/s00223-015-9980-x]
41. Su Y, Leung J, Hans D, Lamy O, Kwok T. The added value of trabecular bone score to FRAX® to predict major osteoporotic fractures for clinical use in Chinese older people: the Mr. OS and Ms. OS cohort study in Hong Kong. Osteoporos Int 2017;28:111-117. [DOI:10.1007/s00198-016-3741-1]
42. Couraud G, Souffir C, Gaigneux E, Kolta S, Roux C, Briot K. Adjusting FRAX® on TBS for identification of subjects at high risk of fractures. Bone 2017;101:214-218. [DOI:10.1016/j.bone.2017.05.005]
43. Garg MK, Kharb S. Dual energy X-ray absorptiometry: Pitfalls in measurement and interpretation of bone mineral density. Indian J Endocrinol Metab 2013;17:203-10. [DOI:10.4103/2230-8210.109659]
44. Saito M, Kida Y, Kato S, Marumo K. Diabetes, collagen, and bone quality. Curr Osteoporos Rep 2014;12:181-8. [DOI:10.1007/s11914-014-0202-7]
45. Illien-Jünger S, lu Y, Qureshi Sh, Hecht AC, Cai W, Vlassara H, et al, Chronic ingestion of advanced glycation end products induces degenerative spinal changes and hypertrophy in aging pre-diabetic mice. PLoS One 2015;10: 0116625. [DOI:10.1371/journal.pone.0116625]
46. Kim JH, Choi HJ, Ku EJ, Kim KM, Kim SW, Cho NH, et al. Trabecular bone score as an indicator for skeletal deterioration in diabetes. J Clin Endocrinol Metab 2015;100:475-82. [DOI:10.1210/jc.2014-2047]
Send email to the article author

Add your comments about this article
Your username or Email:


XML   Persian Abstract   Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Peysepar R, Ghanei L, Ghareh S, Abolghasemi S, Meysamie A, Hoseini P. Comparison of FRAX and FRAX-TBS in predicting osteoprotic fracture risk in postmenopausal women. MEDICAL SCIENCES 2022; 32 (4) :409-418
URL: http://tmuj.iautmu.ac.ir/article-1-1964-en.html

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 32, Issue 4 (winter 2022) Back to browse issues page
فصلنامه علوم پزشکی دانشگاه آزاد اسلامی واحد پزشکی تهران Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch
Persian site map - English site map - Created in 0.05 seconds with 30 queries by YEKTAWEB 4570