Abstract
Studies on trabecular bone score (TBS) in psoriasis are lacking. We aim to assess the association between TBS and inflammation, metabolic syndrome features, and serum adipokines in 29 nondiabetic patients with psoriasis without arthritis, before and after 6-month adalimumab therapy. For that purpose, adjusted partial correlations and stepwise multivariable linear regression analysis were performed. No correlation was found between TBS and disease severity. TBS was negatively associated with weight, BMI, waist perimeter, fat percentage, and systolic and diastolic blood pressure before and after adalimumab. After 6 months of therapy, a negative correlation between TBS and insulin resistance (p = 0.02) and leptin (p = 0.01) and a positive correlation with adiponectin were found (p = 0.01). The best set of predictors for TBS values at baseline were female sex (p = 0.015), age (p = 0.05), and BMI (p = 0.001). The best set of predictors for TBS following 6 months of biologic therapy were age (p = 0.001), BMI (p < 0.0001), and serum adiponectin levels (p = 0.027). In conclusion, in nondiabetic patients with moderate-to-severe psoriasis, TBS correlates with metabolic syndrome features and inflammation. This association is still present after 6 months of adalimumab therapy. Moreover, serum adiponectin levels seem to be an independent variable related to TBS values, after adalimumab therapy.
Highlights
The trabecular bone score (TBS) is a new developed method used to indirectly evaluate bone microarchitecture, providing skeletal data not captured from the standard dualenergy-X-ray absorptiometry (DXA) [1]
We have found that antitumor necrosis factorα agents may improve insulin resistance in patients with moderate-to-severe psoriasis [8], no significant changes in serum leptin or resistin concentrations after 6 months of adalimumab therapy were found [6]. Taking into account these considerations, we aimed to explore the possible association between TBS and inflammation or metabolic syndrome features in nondiabetic patients with moderate-to-severe psoriasis without arthritis, before and after adalimumab therapy
Baseline TBS values were inversely related to some metabolic syndrome features such as blood pressure, obesity parameters, and Castelli index
Summary
The trabecular bone score (TBS) is a new developed method used to indirectly evaluate bone microarchitecture, providing skeletal data not captured from the standard dualenergy-X-ray absorptiometry (DXA) [1]. It consists of a texture parameter that evaluates pixel-gray level variations in the projected lumbar spine DXA image. TBS may be considered as an overall descriptor of bone quality, and lower values have been associated with worse bone structure and high risk of fractures [2]. The utility of TBS in the fracture risk assessment or treatment onset, in patients with osteoporosis, has been addressed in a recent position study by The International Society for Clinical Densitometry [3]. In a cross-sectional, population-based study from Korea, lumbar TBS values were lower in patients with type 2 diabetes mellitus. Participants with low TBS values had more commonly insulin resistance and raised serum highsensitivity C-reactive protein (hs-CRP) levels than those with high values, irrespective of age and body mass index (BMI) [4]
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