Shawwa K, Arabi A, Nabulsi M, Maalouf J, Salamoun M, Choucair M, Hans D, El-Hajj Fuleihan G
Scholars in HeAlth Research Program, American University of Beirut, Beirut, Lebanon.
Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut-Medical Center, Bliss Street, 113-6044, Beirut, Lebanon.
Osteoporos Int. 2016 Feb;27(2):703-10. doi: 10.1007/s00198-015-3255-2. Epub 2015 Sep 1.
Trabecular bone score (TBS) is a DXA-based tool that assesses bone texture and reflects microarchitecture. It has been shown to independently predict the risk of osteoporotic fracture in the elderly. In this study, we investigated the determinants of TBS in adolescents.
TBS is a gray-level textural measurement derived from lumbar spine DXA images. It appears to be an index of bone microarchitecture that provides skeletal information additional to the standard BMD measurement and clinical risk factors. Our objectives were to characterize the relationship between TBS and both age and pubertal stages and identify other predictors in adolescents.
We assessed TBS by reanalyzing spine DXA scan images obtained from 170 boys and 168 girls, age range 10-17 years, gathered at study entry and at 1 year, using TBS software. The results are from post hoc analyses obtained using data gathered from a prospective randomized vitamin D trial. Predictors of TBS were assessed using t test or Pearson's correlation and adjusted using regression analyses, as applicable.
The mean age of the study population was 13.2 ± 2.1 years, similar between boys and girls. Age, height, weight, sun exposure, spine BMC and BMD, body BMC and BMD, and lean and fat mass are all significantly correlated with TBS at baseline (r = 0.20-0.75, p < 0.035). Correlations mostly noted in late-pubertal stages. However, after adjustment for BMC, age remained an independent predictor only in girls.
In univariate exploratory analyses, age and pubertal stages were determinants of TBS in adolescents. Studies to investigate predictors of TBS and to investigate its value as a prognostic tool of bone fragility in the pediatric population are needed.
小梁骨评分（TBS）是一种基于双能X线吸收法（DXA）的工具，用于评估骨纹理并反映微观结构。研究表明，它能独立预测老年人骨质疏松性骨折的风险。在本研究中，我们调查了青少年小梁骨评分的决定因素。
小梁骨评分是一种从腰椎DXA图像得出的灰度纹理测量值。它似乎是骨微观结构的一个指标，能提供除标准骨密度测量值和临床风险因素之外的骨骼信息。我们的目标是描述小梁骨评分与年龄和青春期阶段之间的关系，并确定青少年中的其他预测因素。
我们通过重新分析从170名男孩和168名女孩（年龄范围10 - 17岁）收集的脊柱DXA扫描图像来评估小梁骨评分，这些图像是在研究开始时和1年后收集的，使用小梁骨评分软件。结果来自使用从前瞻性随机维生素D试验收集的数据进行的事后分析。小梁骨评分的预测因素采用t检验或Pearson相关性进行评估，并在适用时使用回归分析进行调整。
研究人群的平均年龄为13.2±2.1岁，男孩和女孩相似。年龄、身高、体重、阳光照射、脊柱骨矿含量（BMC）和骨密度（BMD）、全身BMC和BMD以及瘦体重和脂肪量在基线时均与小梁骨评分显著相关（r = 0.20 - 0.75，p < 0.035）。相关性大多在青春期后期出现。然而，在调整骨矿含量后，年龄仅在女孩中仍是一个独立的预测因素。
在单变量探索性分析中，年龄和青春期阶段是青少年小梁骨评分的决定因素。需要开展研究来调查小梁骨评分的预测因素，并研究其作为儿科人群骨脆性预后工具的价值。
