Comparative effects of lumbar spine bone area from DXA on trabecular bone score and bone mineral density: the Manitoba bone mineral density (BMD) Registry
Authors' conclusion
TBS is largely unaffected by variation in DXA-derived lumbar spine bone area.
Study context
- Population
- Individuals aged ≥ 40 years with baseline lumbar spine trabecular bone score (TBS) and BMD (mean age 63 years, 90% female)
- Participants
- 56,586 individuals
- Exposure
- Effect of lumbar spine bone area on lumbar spine TBS vs BMD
- Outcome
- Least squares mean (LSM) TBS and BMD according to lumbar spine bone area quintile; incident major osteoporotic fractures
Methodological detailsregistry-based (Manitoba BMD Registry), population-based linked healthcare data, Cox regression
- Registry-based (Manitoba BMD Registry)
- Population-based linked healthcare data
- Cox regression
Main finding
As reported in the abstract
Smallest-largest lumbar spine bone area quintile difference
BMD, smallest-largest quintile difference (greater BMD with increasing bone area)
13.2%
TBS, smallest-largest quintile difference
0.6%
BMD, fully adjusted smallest-largest quintile difference
11.3%
TBS, fully adjusted smallest-largest quintile difference
0.3%
Observational data: associations, not effects.
Further findings
- TBS significantly associated with incident major osteoporotic fractures (MOF) in all regression models, independent of other covariates incl. bone area and BMD
- Adjusting for TBS reduced but did not eliminate the effect of bone area
Original publication
Comparative effects of lumbar spine bone area from DXA on trabecular bone score and bone mineral density: the Manitoba BMD Registry. Osteoporos Int. Published 11 December 2025. doi:10. 1007/ s00198-025-07806-5
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