scholarly journals Relationship between Insulin Resistance (HOMA-IR), Trabecular Bone Score (TBS), and Three-Dimensional Dual-Energy X-ray Absorptiometry (3D-DXA) in Non-Diabetic Postmenopausal Women

2020 ◽  
Vol 9 (6) ◽  
pp. 1732
Author(s):  
Francisco Campillo-Sánchez ◽  
Ricardo Usategui-Martín ◽  
Ángela Ruiz -de Temiño ◽  
Judith Gil ◽  
Marta Ruiz-Mambrilla ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Trabecular Bone ◽  
Postmenopausal Women ◽  
Trabecular Bone Score ◽  
Three Dimensional ◽  
Dual Energy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Model Assessment ◽  
Mineral Density ◽  
X Ray

Background: Insulin may play a key role in bone metabolism, where the anabolic effect predominates. This study aims to analyze the relationship between insulin resistance and bone quality using the trabecular bone score (TBS) and three-dimensional dual-energy X-ray absorptiometry (3D-DXA) in non-diabetic postmenopausal women by determining cortical and trabecular compartments. Methods: A cross-sectional study was conducted in non-diabetic postmenopausal women with suspected or diagnosed osteoporosis. The inclusion criteria were no menstruation for more than 12 months and low bone mass or osteoporosis as defined by DXA. Glucose was calculated using a Hitachi 917 auto-analyzer. Insulin was determined using an enzyme-linked immunosorbent assay (EIA). Insulin resistance was estimated using a homeostasis model assessment of insulin resistance (HOMA-IR). DXA, 3D-DXA, and TBS were thus collected. Moreover, we examined bone parameters according to quartile of insulin, hemoglobin A1C (HbA1c), and HOMA-IR. Results: In this study, we included 381 postmenopausal women. Women located in quartile 4 (Q4) of HOMA-IR had higher values of volumetric bone mineral density (vBMD) but not TBS. The increase was higher in the trabecular compartment (16.4%) than in the cortical compartment (6.4%). Similar results were obtained for insulin. Analysis of the quartiles by HbA1c showed no differences in densitometry values, however women in Q4 had lower levels of TBS. After adjusting for BMI, statistical significance was maintained for TBS, insulin, HOMA-IR, and HbA1c. Conclusions: In non-diabetic postmenopausal women there was a direct relationship between insulin resistance and vBMD, whose effect is directly related to greater weight. TBS had an inverse relationship with HbA1c, insulin, and insulin resistance unrelated to weight. This might be explained by the formation of advanced glycosylation products (AGEs) in the bone matrix, which reduces bone deformation capacity and resistance, as well as increases fragility.

Optimizing DXA to Assess Skeletal Health: Key Concepts for Clinicians

2020 ◽  
Vol 105 (12) ◽  
pp. 3784-3791
Author(s):  
Kurt A Kennel ◽  
Jad G Sfeir ◽  
Matthew T Drake
Keyword(s):  
Fracture Risk ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Evidence Synthesis ◽  
Dual Energy ◽  
Care Providers ◽  
Mineral Density ◽  
Skeletal Health ◽  
X Ray ◽  
Osteoporosis Care

Abstract Context The diagnosis of osteoporosis and assessment of fracture risk prior to a sentinel fracture was transformed by the widespread clinical use of dual-energy X-ray absorptiometry (DXA) for the assessment of bone mineral density (BMD). Evidence Acquisition This review is based on a collection of primary and review literature gathered from a PubMed search of “dual energy X-ray absorptiometry,” “trabecular bone score,” and “atypical femur fracture” among other keywords. PubMed searches were supplemented by the authors’ prior knowledge of the subject. Evidence Synthesis While uncertainty exists for some aspects of osteoporosis care, patient and clinician familiarity with BMD assessment for screening and monitoring is firmly established. Beyond BMD, lateral spine images obtained with DXA can diagnose osteoporosis and refine fracture risk through the detection of unrecognized vertebral fractures. In addition, analysis of DXA lumbar spine images can reflect changes in trabecular bone microarchitecture, a component of bone “quality” that predicts risk of fracture independent of BMD. Finally, monitoring of bone health by DXA may be extended to include assessment of the femoral cortices for rare but serious adverse effects associated with antiresorptive therapies. Conclusions Increasing technologic sophistication requires additional consideration for how DXA imaging is performed, interpreted and applied to patient care. As with any test, clinicians must be familiar with DXA performance, pitfalls in analysis, and interpretation within each clinical context in which DXA is applied. With this perspective, care providers will be well positioned to contribute to continuous improvement of DXA performance and, in turn, quality of osteoporosis care.

scholarly journals Bone quality, as measured by trabecular bone score, in patients with primary hyperparathyroidism

2013 ◽  
Vol 169 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Cristina Eller-Vainicher ◽  
Marcello Filopanti ◽  
Serena Palmieri ◽  
Fabio Massimo Ulivieri ◽  
Valentina Morelli ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Trabecular Bone ◽  
Bone Quality ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
Mineral Density ◽  
Texture Measurement ◽  
X Ray ◽  
Spinal Radiograph ◽  
And Gender

ObjectiveIn primary hyperparathyroidism (PHPT), vertebral fractures (VFx) occur regardless of bone mineral density (BMD) and may depend on decreased bone quality. Trabecular bone score (TBS) is a texture measurement acquired during a spinal dual-energy X-ray absorptiometry (DXA). Recently, TBS has been proposed as an index of bone micro-architecture.DesignWe studied 92 PHPT patients (74 females, age 62.1±9.7 years) and 98 control subjects. In all patients at baseline, in 20 surgically treated patients and in 10 conservatively treated patients after 24 months, TBS, spinal (lumbar spine (LS)) and femoral (total hip (TH) and femoral neck (FN)) BMD were assessed by DXA and VFx by spinal radiograph.ResultsPHPT patients had lower TBS (−2.39±1.8) and higher VFx prevalence (43.5%) than controls (−0.98±1.07 and 8.2% respectively, bothP<0.0001). TBS was associated with VFx (odds ratio 1.4, 95% CI 1.1–1.9,P=0.02), regardless of LS-BMD, age, BMI and gender, and showed a better compromise between sensitivity (75%) and specificity (61.5%) for detecting VFx than LS-BMD, TH-BMD and FN-BMD (31 and 75%, 72 and 44.2%, and 64 and 65% respectively). In surgically treated patients, TBS, LS-BMD, TH-BMD and FN-BMD increased (+47±44.8,+29.2±34.1,+49.4±48.7 and +30.2±39.3% respectively, allP<0.0001). Among patients treated conservatively, TBS decreased significantly in those (n=3) with incident VFx (−1.3±0.3) compared with those without (−0.01±0.9,P=0.048), while BMD changes were not statistically different (LS 0.3±1.2 vs −0.8±0.9 respectively,P=0.19; TH 0.4±0.8 vs −0.8±1.4 respectively,P=0.13 and FN 0.4±0.9 vs −0.8±1.4 respectively,P=0.14).ConclusionsIn PHPT, bone quality, as measured by TBS, is reduced and associated with VFx and improves after surgery.

Short-term precision assessment of trabecular bone score and bone mineral density using dual-energy X-ray absorptiometry with different scan modes: an in vivo study

2015 ◽  
Vol 25 (7) ◽  
pp. 2194-2198 ◽  
Author(s):  
Michele Bandirali ◽  
Alessandro Poloni ◽  
Luca Maria Sconfienza ◽  
Carmelo Messina ◽  
Giacomo Davide Edoardo Papini ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
Mineral Density ◽  
Short Term ◽  
X Ray ◽  
Precision Assessment ◽  
Scan Modes

scholarly journals Preliminary result on trabecular bone score (TBS) in lumbar vertebrae with experimentally altered microarchitecture

2013 ◽  
Vol 86 (1) ◽  
Author(s):  
M. Di Stefano ◽  
G.C. Isaia ◽  
D. Cussa ◽  
G.L. Panattoni
Keyword(s):  
Trabecular Bone ◽  
Cancellous Bone ◽  
Trabecular Bone Score ◽  
Lumbar Vertebrae ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
Vertebral Bodies ◽  
Preliminary Research ◽  
Qualitative Parameter

The aim of this preliminary research is to investigate the reliability of a new qualitative parameter, called Trabecular Bone Score (TBS), recently proposed for evaluating the microarchitectural arrangement of cancellous bone in scans carried out by dual energy X-ray absorptiometry (DXA). Vertebral bodies of 15 fresh samples of lumbar spines of adult pig were analysed either in basal conditions and with altered microarchitecture of the cancellous bone obtained by progressive drilling. The examined bony areas do not show changes in bone mineral density (BMD), whereas TBS values decrease with the increasing alteration of the vertebral microtrabecular structure. Our preliminary data seem to confirm the reliability of TBS as a qualitative parameter useful for evaluating the microarchitectural strength in bony areas quantitatively analysed by DXA.

scholarly journals The Trabecular Bone Score as a Predictor for Thalassemia-Induced Vertebral Fractures in Northeastern Thailand

Anemia ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Nattiya Teawtrakul ◽  
Sukanya Chukanhom ◽  
Suranut Charoensri ◽  
Charoonsak Somboonporn ◽  
Chatlert Pongchaiyakul
Keyword(s):  
Trabecular Bone ◽  
Vertebral Fractures ◽  
Trabecular Bone Score ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
X Ray ◽  
Bmd Testing ◽  
Northeastern Thailand

Introduction. Thalassemia bone disease is one of the disease-related complications in patients with thalassemia. Prevalence of fractures and the role of a trabecular bone score (TBS) as a predictive factor for fractures were evaluated in patients with thalassemia. Methods. A cross-sectional study was conducted in patients with thalassemia aged ≥18 years at Srinagarind Hospital, Khon Kaen University, Thailand. A lateral thoracolumbar radiograph and bone mineral density (BMD) at the lumbar spine and hip, as well as the TBS measured by dual-energy X-ray absorptiometry (DXA), were evaluated in all patients. Results. Among 86 patients, 14 patients were found to have radiographic vertebral fracture yielding a prevalence of 16.3%. All patients who had fractures were β-thalassemia/Hb E. Combined low BMD and TBS at lumbar spines and a presence of endocrinopathies were significantly associated with vertebral fractures. Conclusions. The prevalence of vertebral fractures in patients with thalassemia was not uncommon. A combined low BMD and TBS and a presence of endocrinopathies were associated with vertebral fractures. These findings suggested that BMD testing and TBS measurement have a clinical implication as a screening tool for evaluating the risk of vertebral fractures in thalassemic patients, particularly in β-thalassemia/Hb E who have endocrinopathies.

Dual-energy X-ray Absorptiometry Monitoring with Trabecular Bone Score: 2019 ISCD Official Position

2019 ◽  
Vol 22 (4) ◽  
pp. 501-505 ◽  
Author(s):  
Kelly Krohn ◽  
Elliott N. Schwartz ◽  
Yoon-Sok Chung ◽  
E. Michael Lewiecki
Keyword(s):  
Trabecular Bone ◽  
Trabecular Bone Score ◽  
Dual Energy ◽  
X Ray ◽  
Official Position
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