Does Trabecular Bone Score (TBS) improve the predictive ability of FRAX® for major osteoporotic fractures according to the Japanese Population-Based Osteoporosis (JPOS) cohort study?

This study examined whether bone microarchitecture determined by Trabecular Bone Score (TBS) is associated with the risk of major osteoporotic fractures independent of FRAX ® in Japanese women. Participants included 1541 women aged ≥ 40 at baseline. Major osteoporotic fractures during a 10-year foll...

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Bibliographic Details
Published in:Journal of bone and mineral metabolism 2019-01, Vol.37 (1), p.161-170
Main Authors: Tamaki, Junko, Iki, Masayuki, Sato, Yuho, Winzenrieth, Renaud, Kajita, Etsuko, Kagamimori, Sadanobu
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Bone mineral density
Cancellous bone
Cancellous Bone - pathology
Cohort analysis
Cohort Studies
Female
Follow-Up Studies
Fractures
Hip
Humans
Humerus
Incidence
Logistic Models
Medicine
Medicine & Public Health
Metabolic Diseases
Middle Aged
Models, Biological
Original Article
Orthopedics
Osteoporosis
Osteoporotic Fractures - drug therapy
Osteoporotic Fractures - epidemiology
Osteoporotic Fractures - pathology
Population studies
Population-based studies
Radius
Reclassification
Risk Assessment
ROC Curve
Spine
Vertebrae
Young Adult
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Summary:This study examined whether bone microarchitecture determined by Trabecular Bone Score (TBS) is associated with the risk of major osteoporotic fractures independent of FRAX ® in Japanese women. Participants included 1541 women aged ≥ 40 at baseline. Major osteoporotic fractures during a 10-year follow-up period were documented by the Japanese Population-based Osteoporosis Cohort Study. TBS and areal bone mineral density (aBMD) were calculated for the same spinal regions at baseline. To compare the predictive ability of FRAX ® model when used alone versus in combination with TBS, Akaike information criterion (AIC), the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated. We identified 67 events of major osteoporotic fractures. The skeletal sites of the first fracture event were as follows: hip (11), vertebrae (13), radius (42), and humerus (1). The model incorporating FRAX ® [1.35 (95% CI 1.09–1.67) for 1 standard deviation (SD) increase] with TBS [1.46 (95% CI 1.08–1.98) for 1 SD decrease] demonstrated better fit compared to a model consisting of FRAX alone (AIC 528.6 vs 532.7). NRI values for classification accuracy showed significant improvements in the FRAX ® and TBS model, as compared to FRAX ® alone [0.299 (95% CI 0.056-0.541)]. However, there were no significant differences in AUC or IDI between these models. The TBS score is associated with a risk of major osteoporotic fracture independent of FRAX ® score obtained with or without BMD values among Japanese women during a 10-year follow-up period.
ISSN:0914-8779
1435-5604
DOI:10.1007/s00774-018-0910-7