Interdisciplinary Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland.
Arch Osteoporos. 2022 Jun 9;17(1):83. doi: 10.1007/s11657-022-01123-8.
Lumbar spine bone mineral density (BMD) and trabecular bone score (TBS) are both calculated on L1-L4 vertebrae. This study investigated the ability to predict osteoporotic fractures of BMD and TBS as calculated based on all possible adjacent L1-L4 vertebrae combinations. Present findings indicate that L1-L3 is an optimal combination to calculate LS-BMD or TBS.
Lumbar spine (LS) BMD and TBS are both assessed in the LS DXA scans in the same region of interest, L1-L4. We aimed to investigate the ability to predict osteoporotic fractures of all the possible adjacent LS vertebrae combinations used to calculate BMD and TBS and to evaluate if any of these combinations performs better at osteoporotic fracture prediction than the traditional L1-L4 combination.
This study was embedded in OsteoLaus-women cohort in Switzerland. LS-DXA scans were performed using Discovery A System (Hologic). The incident vertebral fractures (VFs) and major osteoporotic fractures (MOFs) were assessed from VF assessments using Genant's method or questionnaires (non-VF MOF). We ran logistic models using TBS and BMD to predict MOF, VF, and non-VF MOF, combining different adjustment factors (age, fracture level, or BMD).
One thousand six hundred thirty-two women (mean ± SD) 64.4 ± 7.5 years, BMI 25.9 ± 4.5 kg/m, were followed for 4.4 years and 133 experienced MOF. The association of one SD decrease L1-L3 BMD with the odds ratios (ORs) of MOF was OR 1.32 (95%CI 1.15-1.53), L2-L4 BMD was 1.25 (95%CI 1.09-1.42), and L1-L4 BMD was 1.30 (95%CI 1.14-1.48). One SD decrease in L1-L3 TBS was more strongly associated with the odds of having a MOF (OR 1.64, 95% CI 1.34-2.00), than one SD decrease in L2-L4 TBS (OR 1.48, 95% CI 1.21-1.81), or in L1-L4 TBS (OR 1.60, CI 95% 1.32-1.95).
Current findings indicate that L1-L3 is an optimal combination for the TBS or LS-BMD calculation.
腰椎（LS）BMD 和 TBS 均在 L1-L4 感兴趣区域的 LS DXA 扫描中进行评估。我们旨在研究计算 BMD 和 TBS 时使用所有可能的相邻 LS 椎骨组合预测骨质疏松性骨折的能力，并评估这些组合中是否有任何组合在预测骨质疏松性骨折方面优于传统的 L1-L4 组合。
本研究嵌入瑞士 OsteoLaus-女性队列中。LS-DXA 扫描使用 Discovery A System（Hologic）进行。使用 Genant 方法或问卷（非 VF MOF）从 VF 评估中评估椎骨骨折（VF）和主要骨质疏松性骨折（MOF）。我们使用 TBS 和 BMD 运行逻辑模型，以预测 MOF、VF 和非 VF MOF，同时结合不同的调整因素（年龄、骨折水平或 BMD）。
1632 名女性（平均±标准差）64.4±7.5 岁，BMI 25.9±4.5kg/m2，随访 4.4 年，133 人发生 MOF。L1-L3 BMD 每降低 1 个标准差，MOF 的比值比（OR）为 1.32（95%CI 1.15-1.53），L2-L4 BMD 为 1.25（95%CI 1.09-1.42），L1-L4 BMD 为 1.30（95%CI 1.14-1.48）。L1-L3 TBS 每降低 1 个标准差与发生 MOF 的几率更密切相关（OR 1.64，95%CI 1.34-2.00），而 L2-L4 TBS（OR 1.48，95%CI 1.21-1.81）或 L1-L4 TBS（OR 1.60，95%CI 1.32-1.95）。
目前的研究结果表明，L1-L3 是 TBS 或 LS-BMD 计算的最佳组合。
