Wu Huan-Hua, Wu Biao, Zhang Shao-Juan, Zhou Zi-Qing, Shang Jing-Jie, Cheng Yong, Mai Jin-Ci, Gong Jian, Xu Hao
Department of Nuclear Medicine, the First Affiliated Hospital, Jinan University, Guangzhou, China.
Quant Imaging Med Surg. 2023 Apr 1;13(4):2478-2485. doi: 10.21037/qims-22-550. Epub 2023 Mar 10.
Trabecular bone score (TBS) is a relatively new gray-level textural parameter that provides information on bone microarchitecture. TBS has been shown to be a good predictor of fragility fractures independent of bone density and clinical risk factors. Estimating the normal reference values of TBS in both sexes among the Chinese population is necessary to improve the clinical fracture risk assessment.
This retrospective study enrolled healthy Chinese participants living in Guangzhou, China, including 1,018 men and 3,061 women (aged 20-74 years). Bone mineral density images were obtained with dual-energy X-ray absorptiometry (DXA) scanning of the lumbar region (L). Lumbar spine TBS values were calculated. The correlations between the scores and bone mineral density, age, height, and weight were calculated for men and women. A TBS reference plot was established in relation to age (20-74 years). Values 2 standard deviations below the mean score for each sex were used as the cutoff values for low-quality bone.
The TBS (L) was significantly higher in Chinese men than in Chinese women. The scores peaked at 25-29 years (1.47±0.08 years) in men and at 20-24 years (1.43±0.08 years) in women. According to the statistical confidence interval, in Chinese males, a TBS ≥1.39 is considered normal, a TBS between 1.31 and 1.39 indicates partially degraded microarchitecture, and a TBS ≤1.31 indicates degraded microarchitecture. In Chinese females, a TBS ≥1.35 is considered normal, a TBS between 1.27 and 1.35 indicates partially degraded microarchitecture, and a TBS ≤1.27 indicates degraded microarchitecture.
This study provides normative reference ranges for the TBS in Chinese men and women. Chinese men with a TBS score ≤1.31 and Chinese women with a TBS score ≤1.27 are can be considered to have reduced bone microarchitecture and may be at higher risk of having osteoporosis fractures.
骨小梁评分（TBS）是一种相对较新的灰度纹理参数，可提供有关骨微结构的信息。已证明TBS是独立于骨密度和临床风险因素的脆性骨折的良好预测指标。估算中国人群中男女TBS的正常参考值对于改善临床骨折风险评估很有必要。
这项回顾性研究纳入了居住在中国广州的健康中国参与者，包括1018名男性和3061名女性（年龄在20 - 74岁之间）。通过腰椎区域的双能X线吸收法（DXA）扫描获得骨密度图像。计算腰椎TBS值。计算男性和女性的评分与骨密度、年龄、身高和体重之间的相关性。建立了与年龄（20 - 74岁）相关的TBS参考图。将低于每种性别平均评分2个标准差的值用作低质量骨的临界值。
中国男性的TBS（L）显著高于中国女性。评分在男性25 - 29岁（1.47±0.08岁）和女性20 - 24岁（1.43±0.08岁）时达到峰值。根据统计置信区间，在中国男性中，TBS≥1.39被认为正常，TBS在1.31至1.39之间表示微结构部分退化，TBS≤1.31表示微结构退化。在中国女性中，TBS≥1.35被认为正常，TBS在1.27至1.35之间表示微结构部分退化，TBS≤1.27表示微结构退化。
本研究提供了中国男性和女性TBS的规范参考范围。TBS评分≤1.31的中国男性和TBS评分≤1.27的中国女性可被认为骨微结构降低，可能有更高的骨质疏松性骨折风险。
