Diagnostic Value of Trabecular Bone Score in Osteoporosis

Abstract

Background: Osteoporosis is a common chronic disease that can cause fractures and other complications. Early diagnosis and prompt treatment of this disease can reduce the risk of fracture. The trabecular bone score (TBS) is a valuable tool for evaluating bone microarchitecture in patients with osteoporosis. Objectives: The present study aimed to evaluate the association of TBS score with bone mineral density (BMD) as the gold standard in patients with osteoporosis. Patients and Methods: This cross-sectional study was performed on 254 patients admitted to Resalat Hospital in Tehran, Iran. The BMD and TBS were concurrently evaluated, and TBS validity for osteoporosis diagnosis was assessed based on BMD as the gold standard. The agreement between TBS and BMD results was measured using the kappa statistic. All analyses were performed in MedCalc version 18.11.3.8 and SPSS version 18, and the level of statistical significance was set at < 0.05. Results: In this study, the majority of the patients were female (88.2%) and younger than 65 years (63.0%). Osteopenia and osteoporosis were diagnosed in 42.1% and 18.9% of the patients, respectively. The sensitivity of TBS for diagnosing osteoporosis versus osteopenia and osteopenia versus a normal status was higher in patients aged ≥ 65 years compared to those aged < 65 years (63.33% vs. 27.78% and 86.66% vs. 63.63%, respectively). Overall, TBS demonstrated a high diagnostic ability for differentiating osteoporosis versus normal BMD (AUC = 0.911, P < 0.001). Conclusion: Based on the findings, TBS alone is not sufficient for diagnosing osteoporosis and cannot replace BMD. Therefore, a combination of BMD and TBS techniques can be the best approach for diagnosing osteoporosis, especially in patients aged ≥ 65 years.