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Horm Metab Res 2021; 53(08): 499-503
DOI: 10.1055/a-1528-7261
Endocrine Care

Clinical Utility of Trabecular Bone Score (TBS) in Fracture Risk Assessment of Patients with Rheumatic Diseases Treated with Glucocorticoids

Anna Nowakowska-Płaza
1   Department of Rheumatology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
,
Jakub Wroński 
1   Department of Rheumatology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
,
Iwona Sudoł-Szopińska
2   Department of Radiology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
,
Piotr Głuszko
1   Department of Rheumatology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
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Abstract

Chronic glucocorticoid therapy is associated with osteoporosis and can cause fractures in up to 50% of patients. Increased risk of fractures in patients with glucocorticoid-induced osteoporosis does not result only from the decreased bone mineral density (BMD) but also bone microarchitecture deterioration. Trabecular bone score (TBS) is a method complementary to DXA, providing additional information about trabecular bone structure. The aim of this study was to assess the clinical utility of TBS in fracture risk assessment of patients treated with glucocorticoids. Patients with rheumatic diseases treated with glucocorticoids for at least 3 months were enrolled. All recruited patients underwent DXA with additional TBS assessment. We analyzed the frequency of osteoporosis and osteoporotic fractures and assessed factors that might be associated with the risk of osteoporotic fractures. A total of 64 patients were enrolled. TBS and TBS T-score values were significantly lower in patients with osteoporosis compared to patients without osteoporosis. Low energy fractures occurred in 19 patients. The disturbed bone microarchitecture was found in 30% of patients with fractures without osteoporosis diagnosis based on BMD. In the multivariate analysis, only TBS and age were significantly associated with the occurrence of osteoporotic fractures. TBS reflects the influence of glucocorticoid therapy on bone quality better than DXA measured BMD and provides an added value to DXA in identifying the group of patients particularly prone to fractures.

Key words

osteoporosis - glucocorticoids - fractures - trabecular bone score

Supplementary Material



Publication History

Received: 24 January 2021

Accepted after revision: 10 June 2021

Article published online:
12 August 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag
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