Association between trabecular bone score and cardiovascular outcomes: a population-level historical cohort study
Authors' conclusion
TBS is a novel cardiovascular risk factor in individuals undergoing osteoporosis assessment.
Study context
- Population
- Individuals aged ≥ 40 years referred to the Manitoba bone mineral density (BMD) Program for DXA between February 28, 1999, and March 20, 2016
- Participants
- 66,572 individuals
- Exposure
- Lower vs higher lumbar spine trabecular bone score (TBS)
- Outcome
- Incident MACE: acute MI, non-hemorrhagic stroke and all-cause mortality
- Follow-up
- Mean observation 9.5 years
Methodological detailshistorical cohort
- Historical cohort
Main finding
MACE per SD decrease in TBS · mean 9.5 years
Fully adjusted HR
1.13
95% CI 1.17–1.30
As reported in the abstract
- Incident major adverse cardiovascular events (MACE)
- 14,833 (22.3%)
- Acute myocardial infarction (MI)
- 2789 (4.2%)
- Stroke
- 2434 (3.7%)
- Died
- 12,410 (18.6%)
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| MACE per SD decrease in TBS, excluding previous CVD | 1.19 (1.16–1.22) | |
| 0.512Adjusted hazard ratio (log scale) |
Individual MACE endpoints
- Significant effects also seen for the individual MACE endpoints
Original publication
Association between trabecular bone score and cardiovascular outcomes: a population-level historical cohort study. Osteoporos Int. Published 9 December 2025. doi:10.
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