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IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Archives of Osteoporosis Pub Date : 2025-03-07 DOI:10.1007/s11657-025-01519-2

Antoine Bouquegneau, François Jouret, Laurence Seidel, Catherine Bonvoisin, Laurent Weekers, Clio Ribbens, Olivier Bruyere, Etienne Cavalier, Pierre Delanaye, Olivier Malaise

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引用次数: 0

摘要

摘要理论依据：本研究以 HR-pQCT 为参考技术，评估了 TBS 对 ESRD 患者骨微结构的估算。主要结果：与 aBMD 不同，TBS 与 vBMD 和骨微结构有明显相关性。意义重大：目的鉴于慢性肾脏病（CKD）患者骨折风险高，评估其骨质脆性的无创技术仍然非常重要。骨小梁评分（TBS）可提供有助于指导治疗和随访决策的额外信息。本研究旨在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，研究 TBS 是否能反映终末期肾病（ESRD）患者的骨微结构。此外，我们还旨在确定与低 TBS 相关的参数。方法纳入了肾移植（KTx）时的 75 名 ESRD 患者。采用双能 X 射线吸收测定法（DXA）对骨矿物质密度（aBMD）进行分析。在 DXA 过程中，对 L1-L4 区域的 TBS 进行了评估。结果在 ESRD 患者中，TBS 为 1.370 的患者年龄较大，体重指数（BMI）较高。与基于 T 评分的分类（≤ -2.5 或 > -2.5）不同，低 TBS 与骨小梁和皮质 vBMD 显著降低、骨小梁骨量分数 (BV/TV) 和骨小梁数量 (Tb.N) 减少以及骨小梁分离度 (Tb.Sp) 增加有关。结论TBS与HR-pQCT测量的骨小梁和皮质参数相关，与aBMD相比，TBS可能为骨微观结构提供了一个补充视角。在进行 KTx 时，低 TBS 似乎比单纯的 aBMD 更能区分 vBMD 明显较低的患者。

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Trabecular bone score to assess bone microarchitecture in end-stage renal disease patients

Summary

Rationale: This study evaluates TBS for estimating bone microarchitecture in ESRD patients using HR-pQCT as the reference technique. Main results: TBS correlates significantly with vBMD and bone microarchitecture, unlike aBMD. Significance: TBS may complement bone health assessment in ESRD patients by offering additional information alongside aBMD.

Purpose

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.

Methods

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.

Results

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).

Conclusion

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.

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来源期刊

Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS

CiteScore

5.50

自引率

10.00%

发文量

133

期刊介绍： Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.