Bouquegneau Antoine, Jouret François, Seidel Laurence, Bonvoisin Catherine, Weekers Laurent, Ribbens Clio, Bruyere Olivier, Cavalier Etienne, Delanaye Pierre, Malaise Olivier
Division of Nephrology-Dialysis and Transplantation, University of Liège (ULiège), CHU Sart-Tilman, Liège, Belgium.
Laboratory of Translational Research in Nephrology, GIGA Institute, Liège, Belgium.
Arch Osteoporos. 2025 Mar 7;20(1):34. doi: 10.1007/s11657-025-01519-2.
This study evaluates TBS for estimating bone microarchitecture in ESRD patients using HR-pQCT as the reference technique.
TBS correlates significantly with vBMD and bone microarchitecture, unlike aBMD.
TBS may complement bone health assessment in ESRD patients by offering additional information alongside aBMD.
Given the high fracture risk, non-invasive techniques for assessing bone fragility in chronic kidney disease (CKD) remain important. Trabecular bone score (TBS) may provide additional information that could help guide treatment and follow-up decisions. The aim of this study is to investigate whether TBS reflects bone microarchitecture in end-stage renal disease (ESRD) patients, using high-resolution peripheral quantitative computed tomography (HR-pQCT) as the reference technique. Additionally, we aim to identify parameters associated with a low TBS.
Seventy-five ESRD patients were included at the time of kidney transplantation (KTx). Areal bone mineral density (aBMD) was analyzed using dual-energy X-ray absorptiometry (DXA). TBS was assessed from the L1-L4 area during DXA. Volumetric BMD (vBMD) and bone microarchitecture at tibia and radius sites were analyzed using HR-pQCT.
In ESRD patients, those with TBS < 1.370 were older and had a higher body mass index (BMI). In contrast to T-score-based classification (≤ -2.5 or > -2.5), low TBS was linked to significantly lower trabecular and cortical vBMD, reduced trabecular bone volume fraction (BV/TV) and trabecular number (Tb.N), and increased trabecular separation (Tb.Sp). In multivariate analysis, older age, higher BMI, and lower Tb.N remained independently associated with low TBS, while no HR-pQCT parameters were linked to low aBMD (T-score ≤ -2.5).
TBS correlates with both trabecular and cortical parameters measured by HR-pQCT, potentially offering a complementary perspective on bone microstructure compared to aBMD. At the time of KTx, a low TBS appears to better discriminate patients with significantly lower vBMD than aBMD alone.
本研究使用高分辨率外周定量计算机断层扫描（HR-pQCT）作为参考技术，评估小梁骨评分（TBS）在估计终末期肾病（ESRD）患者骨微结构方面的作用。
与面积骨密度（aBMD）不同，TBS与体积骨密度（vBMD）和骨微结构显著相关。
TBS可为ESRD患者的骨骼健康评估提供补充信息，与aBMD一起提供更多信息。
鉴于慢性肾病（CKD）患者骨折风险高，评估骨脆性的非侵入性技术仍然很重要。小梁骨评分（TBS）可能提供有助于指导治疗和随访决策的额外信息。本研究的目的是使用高分辨率外周定量计算机断层扫描（HR-pQCT）作为参考技术，调查TBS是否能反映终末期肾病（ESRD）患者的骨微结构。此外，我们旨在确定与低TBS相关的参数。
75例ESRD患者在肾移植（KTx）时被纳入研究。使用双能X线吸收法（DXA）分析面积骨密度（aBMD）。在DXA检查期间从L1-L4区域评估TBS。使用HR-pQCT分析胫骨和桡骨部位的体积骨密度（vBMD）和骨微结构。
在ESRD患者中，TBS＜1.370的患者年龄较大且体重指数（BMI）较高。与基于T值的分类（≤-2.5或＞-2.5）不同，低TBS与显著更低的小梁和皮质vBMD、降低的小梁骨体积分数（BV/TV）和小梁数量（Tb.N）以及增加的小梁间距（Tb.Sp）相关。在多变量分析中，年龄较大、BMI较高和Tb.N较低仍然与低TBS独立相关，而没有HR-pQCT参数与低aBMD（T值≤-2.5）相关。
TBS与通过HR-pQCT测量的小梁和皮质参数相关，与aBMD相比，可能为骨微结构提供补充观点。在肾移植时，低TBS似乎比单独的aBMD能更好地区分vBMD显著更低的患者。
