Trabecular Bone Score Reflects Trabecular Microarchitecture Deterioration and Fragility Fracture in Female Adult Patients Receiving Glucocorticoid Therapy: A Pre-Post Controlled Study

Abstract EN

A recently developed diagnostic tool, trabecular bone score (TBS), can provide quality of trabecular microarchitecture based on images obtained from dual-energy X-ray absorptiometry (DXA).

Since patients receiving glucocorticoid are at a higher risk of developing secondary osteoporosis, assessment of bone microarchitecture may be used to evaluate risk of fragility fractures of osteoporosis.

In this pre-post study of female patients, TBS and fracture risk assessment tool (FRAX) adjusted with TBS (T-FRAX) were evaluated along with bone mineral density (BMD) and FRAX.

Medical records of patients with (n=30) and without (n=16) glucocorticoid treatment were retrospectively reviewed.

All patients had undergone DXA twice within a 12- to 24-month interval.

Analysis of covariance was conducted to compare the outcomes between the two groups of patients, adjusting for age and baseline values.

Results showed that a significant lower adjusted mean of TBS (p=0.035) and a significant higher adjusted mean of T-FRAX for major osteoporotic fracture (p=0.006) were observed in the glucocorticoid group.

Conversely, no significant differences were observed in the adjusted means for BMD and FRAX.

These findings suggested that TBS and T-FRAX could be used as an adjunct in the evaluation of risk of fragility fractures in patients receiving glucocorticoid therapy.