Usefulness of the Trabecular Bone Score in Assessing the Risk of Vertebral Fractures in Patients with Cirrhosis.

Yui Ogiso,Masahito Shimizu,Kayoko Nishimura,Takao Miwa,Kenji Imai,Toshihide Maeda,Atsushi Suetsugu,Koji Takai,Tatsunori Hanai

doi:10.3390/jcm11061562

Yui Ogiso, Masahito Shimizu + Show 7 more

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https://doi.org/10.3390/jcm11061562

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Abstract

The trabecular bone score (TBS), a surrogate measure of bone microarchitecture, provides complementary information to bone mineral density (BMD) in the assessment of osteoporotic fracture risk. This cross-sectional study aimed to determine whether TBS can identify patients with liver cirrhosis that are at risk of vertebral fractures. We enrolled 275 patients who completed evaluations for lumbar BMD, TBS, and vertebral fractures between November 2018 and April 2021. BMD was measured using dual-energy X-ray absorptiometry (DXA), TBS was calculated by analyzing DXA images using TBS iNsight software, and vertebral fractures were evaluated using Genant’s semi-quantitative method with lateral X-ray images. Factors associated with vertebral fractures and their correlation with the TBS were identified using regression models. Of the enrolled patients, 128 (47%) were female, the mean age was 72 years, and 62 (23%) were diagnosed with vertebral fractures. The prevalence of vertebral fractures was higher in women than in men (33% vs. 14%; p < 0.001). The unadjusted odds ratio (OR) of the vertebral fractures for one standard deviation decrease in TBS and BMD was 2.14 (95% confidence interval [CI], 1.69–2.73) and 1.55 (95% CI, 1.26–1.90), respectively. After adjusting for age, sex, and BMD, the adjusted OR of the vertebral fractures in TBS was 2.26 (95% CI, 1.52–3.35). Multivariate linear regression analysis showed that TBS was independently correlated with age (β = −0.211), body mass index (β = −0.251), and BMD (β = 0.583). TBS can help identify patients with cirrhosis at risk of vertebral fractures.

Highlights

Osteoporosis is defined as a systemic skeletal disease characterized by the low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture [1–3]
Among the 299 cirrhotic patients treated at Gifu University Hospital (Gifu, Japan) between November 2018 and April 2021, 24 patients who were not evaluated for bone mineral density (BMD), trabecular bone score (TBS), or vertebral fractures were excluded from the data analysis, and the remaining 275 were enrolled in this cross-sectional study
The findings of this study showed that TBS is associated with vertebral fractures in patients with liver cirrhosis

Summary

Introduction

Osteoporosis is defined as a systemic skeletal disease characterized by the low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture [1–3]. Fractures associated with osteoporosis generally increase after the age of 55 years in women and after 65 years in men, with profound health consequences for older people [3]. Osteoporosis has become a critical health issue in an aging society. Osteoporosis is a common complication of cirrhosis, occurring in 20–30% of patients [4]. It is often overlooked in patients with cirrhosis. Patients with cirrhosis are approximately twice as likely to develop osteoporotic fractures as those without cirrhosis [5]

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