Trabecular Bone Score In Women Research Articles

Sex-specific association of low-renin hypertension with metabolic and musculoskeletal health in Korean older adults.

Low-renin hypertension (LRH) accounts for approximately one-third of patients with hypertension and are more prevalent in women and the older adult population. Previous study has found a link between the renin-angiotensin-aldosterone system (RAAS) and sex hormones. However, there are insufficient data on the relationship between LRH and metabolic or musculoskeletal outcomes in older adults. Among the 343 participants from a population-based cohort study conducted between May 2018 and August 2019, a total of 256 (86 men older than 50 years and 170 postmenopausal women) were included. The presence of LRH was defined as plasma renin activity (PRA) <1 ng/mL/h and systolic blood pressure (BP) ≥130 or diastolic BP ≥80 mmHg based on the 2017 ACC/AHA guidelines. Individuals with missing data, and those who had used medications that could affect PRA within the past six months were excluded. Bone mineral density (BMD), trabecular bone score (TBS), and appendicular lean mass (ALM) index were assessed using dual-energy X-ray absorptiometry; degraded TBS was defined as partially degraded to degraded levels (≤1.350). Muscle function was assessed according to the Asian Working Group for Sarcopenia guidelines. PRA was measured using radioimmunoassay. The median age was 66 [61-72] years, and the body mass index (BMI) was 24.7 [23.0-26.4] kg/m2. Individuals with LRH, accounting for 34.8%, had lower diabetes mellitus; more dyslipidemia; and poorer muscle function, BMD, and TBS than those in the non-LRH group. In addition, PRA was positively correlated with C-peptide, HOMA-IR, TBS, and ALM index. After adjusting for covariates including age and BMI, LRH was negatively associated with femur neck T-score (adjusted β = -0.30, 95% CI [-0.55 to -0.05], p = 0.021) and the presence of LRH was significantly associated with degraded TBS in women (adjusted odds ratio = 3.00, 95% CI [1.36-6.58], p = 0.006). Our findings suggest that LRH can influence clinical features and metabolic risk in older adults. Notably, LRH in postmenopausal women was linked to lower femur neck T-scores and degraded TBS, indicating sex-specific effects of LRH on bone health. Larger prospective studies are required to elucidate how changes in the RAAS affect metabolic and musculoskeletal outcomes in older adults.

Abstract P3-03-26: Osteopenia and osteoporosis in women with breast cancer in Taiwan: single center retrospective data

Abstract Purpose: Osteopenia and osteoporosis are commonly encounter in elder women. One third of women elder than fifty years suffer a fracture second to osteoporosis around the world. Standard treatments for breast cancer such as chemotherapy or hormonal therapy may increase the risk of both osteopenia and osteoporosis. Premenopausal women treated with standard adjuvant chemotherapy frequently develop ovarian failure, or early menopause, which is associated with accelerated bone loss. Trabecular bone score (TBS), an index extracted by DXA that provides an indirect measurement of bone axial microarchitecture. In addition to the BMD, TBS are warranted to improve the prediction of fracture risk at the individual level. However, due to regulations of National Health Insurance in Taiwan, data are limited on the incidence of osteopenia and osteoporosis in women with breast cancer in Taiwan. In this study, we investigated the proportion of osteopenia and osteoporosis in women with breast cancer in Taiwan. Materials and Methods: There were enrolled 201 female who diagnosed with breast cancer between May 2019 and December 2020 in this retrospective study. Patients with bone metastasis (n=11) and double cancer(n=3) were excluded. All patients received dual energy X-ray absorptiometry (DXA) at least once, including bone mineral density (BMD), T-score (spine and total hip) and trabecular bone score (TBS) data. The data were retrospectively analyzed baseline age, BMD, breast cancer type, aromatase inhibitors (AIs) usage status by Kruskal-Wallis test. Results: Basing on the lowest T-score from measurements at the spine or total hip, 58.8% (n=110) of osteopenia (-2.5≤T←1) and 27.8%(n=52) of osteoporosis (T←2.5) were identified in women with breast cancer (figure1). Statistics significance was noted in patients’ age and BMI between three groups. There was no difference in bone mineral density according to breast cancer subtype. (table 1) Patients who ever use aromatase inhibitors (n=90) had lower BMD (T=-2.14) and trabecular bone score (TBS=1.3) than non-AI group (n=97, T=-1.84, TBS=1.34). (figure 2) (table 2) Conclusions: According to Taiwan’s NHI sampling data from 1999 to 2001, the averaged prevalence of osteoporosis in those aged ≥50 years was 11.35% for women. Breast cancer survivors are at higher risk for osteopenia and osteoporosis compared to cancer-free women in Taiwan. Aromatase inhibitors (AIs) group had lower BMD and TBS (p&amp;lt; 0.05). In our study, forty percent of TNBC patients diagnosed osteoporosis, which is compatible with increased bone loss due to chemotherapy-induced ovarian failure. Therefore, clinicians should be aware not only of AI-associated bone loss but also of patients who ever accepted long-term chemotherapy. A normal range for TBS values in postmenopausal women has been proposed: a TBS of ≥1.350 is considered normal; a TBS between 1.20 and 1.35 is considered consistent with partially degraded microarchitecture, and a TBS of ≤ 1.200 defines degraded microarchitecture. In our study, mean TBS in women with breast cancer (n=187) is 1.32. Further research is needed to determine the validity of cut-points for guiding treatment decisions. Figure 1. Inclusion/exclusion criteria and flow chart Figure 1. Inclusion/exclusion criteria and flow chart Table 1 Figure 2. Aromatase inhibitors group had lower BMD and Trabecular bone score Figure 2. Aromatase inhibitors group had lower BMD and Trabecular bone score Citation Format: Chia-Hua Liu, Chih-Chiang Hung, I-Chen Tsai. Osteopenia and osteoporosis in women with breast cancer in Taiwan: single center retrospective data [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-26.

Association of short sleep duration and trabecular bone score

Short sleep duration has been found to be associated with bone health deterioration by using bone mineral density (BMD). Only a few attempts have been made to assess the association of sleep duration and bone by utilizing the trabecular bone score (TBS). The aim of this study was to examine the association between sleep duration and TBS from a national database. A total of 4480 eligible participants older than 20 years who attended the United States National Health and Nutrition Examination Survey (NHANES) from 2005 to 2006 with TBS data and self-reported sleep duration. The association between sleep duration and TBS was investigated using a multivariate regression model with covariate adjustment. TBS was lowest in individuals with a short sleep duration (≤ 5 h) and it was increased in those with longer self-reported total sleep times. After a full adjustment for covariates, those sleeping less than 5 h had a significantly lower TBS than the reference group (sleep duration of 7 h). In subgroup analyses, an association between short sleep duration (≤ 5 h) and lower TBS persisted in older ages (≥ 60 years old), women, obese adults (BMI ≥ 30 kg/m2), and non-Hispanic Whites. Short sleep duration is associated with low TBS in women, obese adults (BMI ≥ 30 kg/m2), and non-Hispanic whites. Strict self-monitoring of body weight, well-tailored controls of underlying disease(s), and adequate sleep may help prevent osteoporosis.

Качество костной ткани и ее минеральная плотность у больных хронической обструктивной болезнью легких

Цель — изучение влияния хронической обструктивной болезни легких (ХОБЛ) на минеральную плотность костной ткани (МПКТ) и ее качество в зависимости от тяжести заболевания и возраста женщин. Материалы и методы. Обследовано 30 женщин в возрасте 57,43 ± 7,87 года, больных ХОБЛ различной стадии (GOLD 1–4). Исследовали МПКТ всего скелета, поясничного отдела позвоночника (L1–L4), шейки бедренной кости и дистального отдела костей предплечья с помощью двухэнергетической рентгеновской абсорбциометрии (DЕХА). Показатель trabecular bone score (TBS) поясничного отдела позвоночника (L1–L4) определяли с помощью методики TBS iNsight (Med-Imaps, Pessac, Франция). Результаты. Установлено достоверное уменьшение МПКТ на всех исследуемых участках скелета у больных, начиная с GOLD 3, тогда как на уровне L1–L4 МПКТ начинала снижаться при GOLD 2 и в возрастной группе 45–59 лет по сравнению с более молодыми пациентами. Установлены корреляционные связи тяжести ХОБЛ и МПКТ бедренной кости (r = –0,75, p &lt; 0,05), лучевой кости (r = –0 73, p &lt; 0,05), L1–L4 (r = –0,80, p &lt; 0,05), всего скелета (r = –0,73, p &lt; 0,05). Значения TBS, начиная с GOLD 2, а также у женщин старше 45 лет соответствовали частичному нарушению качества кости. TBS прогрессивно снижалась и при GOLD 4 и у женщин старше 60 лет соответствовала значительной потере качества костной ткани. Наиболее выраженные изменения выявлены на уровне TBS L1 и соответствовали значительной потере качества костной ткани уже при GOLD 2. Установлены отрицательные корреляционные связи между тяжестью ХОБЛ и TBS L1–L4 (r = –0,76, p &lt; 0,05) и TBS L2–L4 (r = –0,75, p &lt; 0,05). Выводы. Возраст в равной степени влияет как на МПКТ, так и TBS больных ХОБЛ женщин, и, начиная с 45-летнего возраста, данные показатели прогрессивно снижаются. Влияние ХОБЛ на костную ткань в зависимости от тяжести заболевания неоднородно в разных сегментах аксиального скелета. Самые ранние изменения касаются МПКТ L1–L4 (1,19 ± 0,05) г/см2 по сравнению с GOLD 1 (1,39 ± 0,05) г/см2 (p &lt; 0,05) и TBS L1 (1,17 ± 0,06) по сравнению с GOLD 1 (1,34 ± 0,06; p &lt; 0,05), снижение которых наблюдается уже у больных с GOLD 2.

Trabecular Bone Score in Women With Differentiated Thyroid Cancer

Introduction: Thyrotropin stimulating hormone (TSH) suppression in patients with differentiated thyroid cancer (DTC) aims to decrease the growth and proliferation of thyroid cancer cells. However, the effect of TSH suppressive therapy on bone microarchitecture remains undefined. Methods: Cross-sectional study including 43 women with DTC undergoing TSH suppressive therapy (sTSH) compared to 20 women also on levothyroxine therapy but with TSH in the low-normal range (nTSH) since the thyroid surgery. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA), and trabecular bone score (TBS) was evaluated using the TBS iNsigth software. The relationship between suppressive therapy-related parameters and bone parameters was investigated. Results: The TBS mean values were not significantly different in the sTSH and nTSH groups (1.273 ± 0.12 vs 1.307 ± 0.14, p = 0.7197). In both groups, postmenopausal women had degraded microarchitecture (TBS 1.216 ± 0.11 vs 1.213 ± 0.09, p = 0.9333), while premenopausal women had normal microarchitecture (1.328 ± 0.11 vs 1.401 ± 0.12, p = 0.195). The percentage of all postmenopausal women with degraded TBS was 54.7%, while the percentage of osteoporosis diagnoses was 16.1%. Body mass index (BMI) and menopausal status were the only variables associated with TBS and BMD. Conclusion: Long-term TSH suppressive therapy does not seem to be associated with deterioration of the trabecular microarchitecture in premenopausal women. However, lower TBS values were observed in postmenopausal women of both groups, even in those with nonsuppressive therapy. These data show that treatment with thyroid hormone in DTC can be detrimental to bone quality in postmenopausal women, regardless of whether TSH levels are maintained chronically suppressed or in the low-normal range.

Trabecular bone score in women with differentiated thyroid cancer on long-term TSH-suppressive therapy.

Thyrotropin stimulating hormone (TSH) suppression in patients with differentiated thyroid cancer (DTC) aims to decrease the growth and proliferation of thyroid cancer cells. However, the effect of TSH-suppressive therapy on bone microarchitecture remains undefined. Cross-sectional study including 43 women with DTC undergoing TSH-suppressive therapy (sTSH) compared to 20 women also on levothyroxine (LT4) therapy but with TSH in the low-normal range (nTSH) since the thyroid surgery. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA), and trabecular bone score (TBS) was evaluated using the TBS iNsigth software. Fracture risk assessed by FRAX, with and without TBS, was calculated. The relationship between suppressive therapy-related parameters and bone parameters was investigated. The TBS mean values were not significantly different in the sTSH and nTSH groups (1.273 ± 0.12 vs 1.307 ± 0.14, p = 0.7197). In both groups, postmenopausal women had degraded microarchitecture (TBS 1.216 ± 0.11 vs 1.213 ± 0.09, p = 0.9333), while premenopausal women had normal microarchitecture (1.328 ± 0.11 vs 1.401 ± 0.12, p = 0.195). The percentage of all postmenopausal women with degraded TBS was 54.7%, while the percentage of osteoporosis diagnoses was 16.1%. The TBS-adjusted FRAX-probability of fracture was similar in sTSH and nTSH groups. Body mass index (BMI) and menopausal status were the only variables associated with TBS and BMD. Trabecular microarchitecture assessed by TBS was similar between women on long-term suppressive therapy in DTC and those on LT4 replacement therapy aiming at a TSH level within the low-normal reference range. Low TBS values were observed in postmenopausal women of both groups, suggesting that not only suppressed TSH levels but also a low-normal TSH is associated with deteriorated bone microarchitecture in postmenopausal women following total thyroidectomy.

Identification of Novel Genetic Variants Related to Trabecular Bone Score in Community-Dwelling Older Adults.

BackgroundAs the genetic variants of trabecular bone microarchitecture are not well-understood, we performed a genome-wide association study to identify genetic determinants of bone microarchitecture analyzed by trabecular bone score (TBS).MethodsTBS-associated genes were discovered in the Ansung cohort (discovery cohort), a community-based rural cohort in Korea, and then validated in the Gene-Environment Interaction and Phenotype (GENIE) cohort (validation cohort), consisting of subjects who underwent health check-up programs. In the discovery cohort, 2,451 participants were investigated for 1.42 million genotyped and imputed markers.ResultsIn the validation cohort, identified as significant variants were evaluated in 2,733 participants. An intronic variant in iroquois homeobox 3 (IRX3), rs1815994, was significantly associated with TBS in men (P=3.74E-05 in the discovery cohort, P=0.027 in the validation cohort). Another intronic variant in mitogen-activated protein kinase kinase 5 (MAP2K5), rs11630730, was significantly associated with TBS in women (P=3.05E-09 in the discovery cohort, P=0.041 in the validation cohort). Men with the rs1815994 variant and women with the rs11630730 variant had lower TBS and lumbar spine bone mineral density. The detrimental effects of the rs1815994 variant in men and rs11630730 variant in women were also identified in association analysis (β=−0.0281, β=−0.0465, respectively).ConclusionIn this study, the rs1815994 near IRX3 in men and rs11630730 near MAP2K5 in women were associated with deterioration of the bone microarchitecture. It is the first study to determine the association of genetic variants with TBS. Further studies are needed to confirm our findings and identify additional variants contributing to the trabecular bone microarchitecture.

Physical and lifestyle factors associated with trabecular bone score values.

Trabecular bone score (TBS) indirectly assesses trabecular microarchitecture at the lumbar spine, providing complementary information to areal BMD. Many studies have investigated the relationships between BMD and lifestyle factors known to affect bone, but such research is limited for TBS. The aim of this study was to assess the relationship between TBS and lifestyle factors in Australian men and women. This cross-sectional study involved 894 men and 682 women (ages 24-98years) enrolled in the Geelong Osteoporosis Study. TBS was assessed by analysis of lumbar spine DXA scans (Lunar Prodigy) using TBS iNsight software (Version 2.2). Bivariate and multivariable linear regression models were used to explore the associations between TBS and physical and lifestyle factors, including anthropometry, alcohol consumption, childhood physical activity, mobility, smoking status, prior low trauma fracture, medication use, and intakes of calcium and vitamin D. In bivariate regression modelling, low mobility and the use of antiresorptive medication were associated with lower TBS in both men and women. Low childhood physical activity was also associated with lower TBS in men. Prior fracture, use of glucocorticosteroids, and total calcium intake were also associated with lower TBS in women. The final adjusted model for men included age, weight, childhood physical activity, and BMD, and for women, age, height, BMD, and mobility. No interaction terms were identified in the models. Lower TBS is associated with older age, increased weight, low childhood physical activity, and lower BMD in men and older age, shorter stature, lower BMD, and low mobility in women.

Description of Normative Spine TBS Data for Men and Women in Mexican Population

Trabecular Bone Score (TBS) has proven its usefulness to improve areal Bone Mineral Density in diagnosing fracture risk and bone status evaluation. For it to be better interpreted, local reference values are recommended to account for population differences and, if possible, both in women and men, the former being scarcer. Using TBS, we reanalyzed data obtained from the Mexican population included in the Latin American Vertebral Osteoporosis Study and the Mexican Vertebral Study in men that included a random probability sample of 408 women and 414 men aged 50 and older without fractures. Data was used to obtain reference curves in such a population. Mean TBS in women ranged from an average of 1.359 ± 0.118 standard deviation (SD) 50 to 59 and decreased down to 1.211 ± 0.128 SD in women 80 and above. In men ranged from 1.382 ± 0.116 SD in the first group down to 1.315 ± 0.118 SD in the latter with little differences in age groups. Mean values in women are lower than previously suggested cutoff points to establish microarchitecture status using TBS: 1.350 and above normal, 1.200 to 1.349 partially degraded and 1.199 and below, degraded. Our TBS data have the strength of being a random sample drawn from the population, although limited in its extent to one city in Mexico. The means and curves may be used to diagnose bone status with better sensibility and specificity, although these values are yet to be evaluated.

Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia

BackgroundAs the general population is aging worldwide, the incidence of sarcopenia and osteoporosis is also rapidly increasing. Studies have found the link between sarcopenia and osteoporosis, but the relationship between sarcopenia and osteoporosis, especially bone microarchitecture, remains unclear.AimsTo investigate the relationship between components of sarcopenia (muscle mass, handgrip strength, and gait speed) and components of osteoporosis [bone mass measured by bone mineral density (BMD) and bone microarchitecture measured by trabecular bone score (TBS)] in Chinese subjects.Methods318 Chinese men and 203 Chinese women were included in our study. Muscle mass and BMD were measured by dual-energy X-ray absorptiometry (DXA). TBS iNsight® software was used for TBS. Jamar hydraulic hand dynamometer was used to assess muscle strength, and gait speed was used to assess physical performance.ResultsWe found that the relative appendicular skeletal muscle mass (RASM) in both genders and handgrip strength in women correlated positively with TBS, RASM in men and handgrip strength in women correlated positively with BMDs. In the multiple linear regression model, RASM was positively associated with TBS in both genders, but no significant association was observed between RASM and BMDs. Interestingly, handgrip strength showed positive association with all evaluated BMDs and TBS in women, but not in men. Women with sarcopenia had lower TBS and BMDs at all evaluated sites. Men with sarcopenia had lower BMDs only at femur neck and total hip.ConclusionsThe reduction of muscle mass and strength was significantly associated with decreased bone mass and deteriorated bone microarchitecture. More importantly, low muscle mass is an independent risk factor for bone microarchitecture in Chinese subjects.

VITamin D and OmegA-3 TriaL (VITAL) bone health ancillary study: clinical factors associated with trabecular bone score in women and men.

We investigated whether TBS differs by sex, race, body mass index (BMI), and other clinical variables. The VITamin D and OmegA-3 TriaL (VITAL) is determining effects of vitamin D3 and/or omega-3 fatty acid (FA) supplements in reducing risks of cancer and cardiovascular disease. In the VITAL: Effects on Bone Structure/Architecture ancillary study, effects of these interventions on bone will be investigated. Here, we examine the associations of clinical risk factors with TBS assessments at baseline in the bone health sub-cohort, comprised of 672 participants (369 men and 303 women), mean (± SD) age 63.5 ± 6.0years; BMI ≤ 37kg/m2, no bisphosphonates within 2years or other bone active medications within 1year. TBS was greater in men than women (1.311 vs. 1.278, P < 0.001) and lower with elevated BMIs (P < 0.001), higher age (P = 0.004), diabetes (P = 0.008), SSRI use (P = 0.044), and high alcohol intake (P = 0.009). There was a trend for history of fragility fractures (P = 0.072), and lower TBS. TBS did not vary when analyzed by race, smoking, history of falls, and multivitamin or caffeine use. Lower TBS was associated with female sex, aging, BMI ≥ 25kg/m2, SSRI use, alcohol use, and presence of diabetes; there was a trend between lower TBS and history of fragility fractures. TBS may be useful clinically to assess structural changes that may be associated with fractures among patients who are overweight or obese, those on SSRIs, or with diabetes. Ongoing follow-up studies will clarify the effects of supplemental vitamin D3 and/or FA's on TBS and other bone health measures. NCT01747447.

The association of cortisol and adrenal androgen with trabecular bone score in patients with adrenal incidentaloma with and without autonomous cortisol secretion.

One study in Caucasians has assessed trabecular bone score (TBS), an index of bone microstructure, in adrenal incidentaloma (AI) patients with subclinical hypercortisolism (SH). There are ethnic differences in cortisol sensitivities between Caucasian and Asian populations. We investigated the associations of cortisol and the adrenal androgen dehydroepiandrosterone-sulfate (DHEA-S) with TBS in AI patients with SH, adrenal Cushing's syndrome (CS), and nonfunctional AI (NFAI). We measured TBS, cortisol levels after the overnight 1mg dexamethasone suppression test (1mg DST), and cortisol/DHEA-S in 61 patients with SH (30 men; 31 women), 19 with adrenal CS (4 men; 15 women), and 355 with NFAI (213 men; 142 women). After adjusting for confounders, the serum cortisol level after 1mg DST was inversely correlated with TBS in men (β = -0.133, P = 0.045) and women (β = - 0.140, P = 0.048). Higher cortisol/DHEA-S ratio was associated with lower TBS in women (β = - 0.252, P < 0.001), but not men. This inverse association of cortisol/DHEA-S ratio in women remained statistically significant after adjusting for the serum cortisol level after 1mg DST (β = - 0.221, P = 0.008). Compared with women with NFAI, women with SH had 2.2% lower TBS (P = 0.040). Deteriorated bone microstructure (TBS < 1.230) was associated with the serum cortisol level after 1mg DST (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.04-4.53) and cortisol/DHEA-S ratio (OR, 2.05; 95% CI, 1.03-4.08). Subtle cortisol excess in both genders and reduced DHEA-S, especially in women, may contribute to impaired bone quality in Asian patients with SH.

Establishment of TBS reference plots and correlation between TBS and BMD in healthy mainland Chinese women.

The trabecular bone score (TBS) was obtained from the gray levels of a dual X-ray absorptiometry (DXA) image to evaluate bone microarchitecture. Here, we established the reference plots of TBS in healthy Chinese women of Nanjing area. The TBS references are similar with French and US Caucasian women but higher than Japanese women. The aim of the study was to establish the reference plots of the TBS in healthy Chinese women of the Nanjing area. A total of 537 healthy Chinese women of the Nanjing area were recruited, and the study was approved by the Ethics Committee of the First Affiliated Hospital with Nanjing Medical University. The TBS of the lumbar spine and the bone mineral density (BMD) of the lumbar spine and femur were measured using dual X-ray absorptiometry. The mean ± standard deviation (SD) of the TBS in women with different age groups was calculated. The correlation of TBS and age and BMD was calculated using regression analysis. The reference plots of the TBS were established in healthy Chinese women of the Nanjing area between the ages of 20 and 89 years. The average TBS for total subjects was 1.32 ± 0.11 and reached the peak at the age of 20-29 years and then decreased with age thereafter. The determinant coefficient between TBS and age was 0.5065 while between TBS and BMD was 0.5191. After adjusting for lumbar total BMD, the TBS significantly correlated with age in whole subjects and only in the subgroup of ages 50-59 years. This study suggested that TBS decreased with age and correlated positively with BMD. The TBS reference of Chinese women is similar with those of French and US Caucasian women but higher than that of Japanese women. Furthermore, the TBS may be more significantly applied in women in menopause for less than 10 years.