Automated abdominal aortic calcification and trabecular bone score independently predict incident fracture during routine osteoporosis screening
Authors' conclusion
In conclusion, high ML-AAC24 is associated with lower TBS in older adults attending routine osteoporosis screening. Both measures were associated with incident fractures.
Study context
- Population
- Individuals attending routine osteoporosis screening, Manitoba BMD Registry; mean age 75.3 yr, 93.4% women93.4% women
- Participants
- 7,691 individuals
- Exposure
- High vs moderate vs low ML-AAC24; Trabecular bone score (TBS) per SD decrease
- Outcome
- Any incident fracture (simultaneous associations of ML-AAC24 and TBS)
Methodological detailscross-sectional and longitudinal analyses, machine learning algorithm (ML-AAC24), multivariable-adjusted
- Cross-sectional and longitudinal analyses
- Machine learning algorithm (ML-AAC24)
- Multivariable-adjusted
Main finding
As reported in the abstract
Any incident fracture
Estimate (95% CI)
High ML-AAC24vs Low ML-AAC24independent of TBS and established fracture risk factors
HR 1.41(1.15–1.73)
Lower TBSindependent of ML-AAC24 and established fracture risk factors
HR per SD decrease 1.13(1.05–1.22)
Observational data: associations, not effects.
Further findings
ML-AAC24 category distribution at baseline
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident major osteoporotic fractureHigh ML-AAC24vs Low ML-AAC24 | 1.48 (1.18–1.87) | |
| Incident hip fractureHigh ML-AAC24vs Low ML-AAC24 | 1.56 (1.05–2.31) | |
| 0.512Hazard ratio (log scale) |
Incident major osteoporotic fracture
| HR per SD decrease (95% CI) | ||
|---|---|---|
| Lower TBS | 1.15 (1.06–1.25) | |
| 0.512Hazard ratio per SD decrease (log scale) |
Incident hip fracture
| HR per SD decrease (95% CI) | ||
|---|---|---|
| Lower TBS | 1.25 (1.08–1.44) | |
| 0.512Hazard ratio per SD decrease (log scale) |
TBS (cross-sectional) · baseline
- High vs low ML-AAC24: lower TBS (multivariable-adjusted)
- 0.81%
- Generalized linear regression
Original publication
Automated abdominal aortic calcification and trabecular bone score independently predict incident fracture during routine osteoporosis screening. J Bone Miner Res. Published 10 October 2025. doi:10.
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