Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
BMC Geriatr. 2021 Jul 27;21(1):444. doi: 10.1186/s12877-021-02375-8.
Bone mineral density (BMD) and trabecular bone score (TBS) are moderately correlated. TBS is sometimes used as an adjuvant to BMD in the fracture risk assessment. Some individuals with normal BMD or osteopenia, have more degraded TBS. We aimed to identify factors associated with TBS worse than BMD in the non-osteoporotic elderly population.
The study subjects were selected from 2384 women and men aged ≥60 years participating in the second stage of the Bushehr Elderly Health program, a population-based prospective cohort study in Iran. The BMDs of different sites and the lumbar spine texture were measured using dual-energy X-ray absorptiometry and the TBS algorithm, respectively. Subjects were categorized based on their BMD and TBS status. Logistic regression was performed to identify the factors associated with "TBS worse than BMD" in non-osteoporotic individuals.
Of 1335 participants included in the study, 112 of 457 women, and 54 of 878 men had worse TBS than BMD. In multivariable analysis, TBS worse than BMD in women was statistically significantly associated with years since menopause (OR: 1.04 (1.00-1.07)) and waist circumference (OR: 1.09 (1.05-1.14)). However, in men, the condition was statistically significantly associated with waist circumference (OR: 1.10 (1.03-1.17)), current smoking (OR: 2.54 (1.10-5.84)), and HDL-C (OR: 1.03 (1.00-1.06)).
The results of the study show that higher waist circumference is associated with more degraded TBS than BMD in both men and women. Years passed since menopause and current smoking, respectively in women and men, were associated with more degraded TBS. Considering TBS values in older individuals with higher waist circumference, or a history of smoking despite normal BMDs might help more accurate assessment of bone health. However, further studies are required to confirm the benefit.
骨密度（BMD）和小梁骨评分（TBS）中度相关。TBS 有时被用作骨折风险评估中 BMD 的辅助指标。一些 BMD 正常或骨量减少的个体，TBS 更差。我们旨在确定与非骨质疏松老年人群中 TBS 差于 BMD 相关的因素。
本研究对象选自伊朗基于人群的前瞻性队列研究——布什尔老年健康计划第二阶段的 2384 名年龄≥60 岁的女性和男性。使用双能 X 射线吸收仪测量不同部位的 BMD，使用 TBS 算法测量腰椎骨纹理。根据 BMD 和 TBS 状况对受试者进行分类。采用 Logistic 回归分析确定非骨质疏松个体中与“TBS 差于 BMD”相关的因素。
在纳入的 1335 名参与者中，457 名女性中有 112 名，878 名男性中有 54 名 TBS 差于 BMD。多变量分析显示，女性 TBS 差于 BMD 与绝经年限（OR：1.04（1.00-1.07））和腰围（OR：1.09（1.05-1.14））呈统计学显著相关。然而，在男性中，这种情况与腰围（OR：1.10（1.03-1.17））、当前吸烟（OR：2.54（1.10-5.84））和高密度脂蛋白胆固醇（OR：1.03（1.00-1.06））呈统计学显著相关。
研究结果表明，较高的腰围与男女 TBS 差于 BMD 有关。绝经年限和当前吸烟分别与女性和男性 TBS 差有关。对于腰围较大或有吸烟史但 BMD 正常的老年个体，考虑 TBS 值可能有助于更准确地评估骨骼健康。但是，需要进一步的研究来证实其益处。
