Relationship between lumbar spine BMD and trabecular bone score in men with and without soft tissue artefacts — ASN Events
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Relationship between lumbar spine BMD and trabecular bone score in men with and without soft tissue artefacts (#60)

Kara B Anderson 1 , Kara L Holloway 1 , Mark A Kotowicz 1 2 3 , Julie A Pasco 1 2 3
  1. Deakin University, Geelong, VIC, Australia
  2. Melbourne Medical School, The University of Melbourne, St Albans, Victoria, Australia
  3. Barwon Health, Geelong, Victoria, Australia

Background

In men, areal BMD at the lumbar spine (LSBMD) has been shown to increase with increasing age1. However, this apparent increase is a result of artefacts including osteophytes, aortic calcification, fractures, scoliosis and osteoarthritis. Exclusion of individuals with artefacts results in a decrease of LSBMD with increasing age. The aim of this study is to investigate whether TBS is similarly affected by the presence of artefacts in men.

Methods

This study included 397 men aged 40-90 years enrolled in the Geelong Osteoporosis Study. TBS was determined retrospectively using TBS iNsight software (Version 2.1) from lumbar spine DXA scans (Lunar Prodigy). Artefacts were also identified from examination of these scans. Using multivariable regression techniques the relationship between LSBMD and TBS was assessed, adjusting for age and presence of artefacts.

Results

Of 397 men, 132 (33.25%) had no artefacts, whereas 265 (66.75%) were identified as having one or more artefacts in lumbar spine DXA scans. From the multivariable regression analysis, for a given TBS, mean LSBMD was greater for men with artefacts (1.337 g/cm2, 95%CI 1.314-1.360) than those without artefacts (1.165 g/cm2, 95%CI 1.130-1.200). This association persisted after adjustment for age. However, there was some evidence that age was an effect modifier such that the difference increased with increasing age.

Discussion

The results of this study indicate that TBS is less affected by artefacts than LSBMD. This suggests that TBS could be a particularly useful tool in fracture risk prediction for older men with conditions that artefactually increase measures of BMD traditionally used to predict fracture risk.

 

  1. 1. Henry, M.J. et al., 2010. Bone mineral density reference ranges for Australian men: Geelong osteoporosis study. Osteoporosis International, 21(6), pp.909–917.