Assessment of women microarchitecture with and without osteoporotic fracture by TBS on white non Hispanic US women

Abstract

[95% CI 1.16-1.250, P<0.001; hip fracture 1.14 [95% CI 1.05-1.23), P=0.001). Results were largely unaffected by including lumbar spine BMD or spine-hip Tscore “offset” in the model. A preliminary method to adjust FRAX probability based upon lumbar spine TBS tertile is shown in the Table. When used to reclassify fracture risk, this gave a significant increase in integrated discrimination index for MOF (+1.3%, P<0.001) and hip fracture (+1.3%, P<0.001), with net reclassification improvement +4.6% for MOF (P<0.001). There was an age interaction with larger TBS effects in younger than older women age for MOF (P<0.001) and hip fracture (P=0.002). In summary, an incremental improvement in fracture prediction was seen by using lumbar spine TBS in combination with FRAX. An approach that addresses the age-TBS interaction may be required. If validated in other prospective cohorts, lumbar spine TBS may become clinically useful for enhancing fracture prediction from FRAX.