Contributions of Clinical and Technical Factors to Longitudinal Change in Trabecular Bone Score and Bone Density: A Registry-Based Individual-Level Analysis
Authors' conclusion
In summary, change in spine TBS using the present algorithm appears to be strongly affected by technical factors.
Study context
- Population
- Individuals age ≥40 years with two fan-beam DXA scans on the same instrument within 5 years (mean interval 3.2 years), Manitoba DXA Registry; 6985 (60.0%) received antiresorptive osteoporosis medication (majority oral bisphosphonate) between scans
- Participants
- 11,643 participants
- Outcome
- Change in lumbar spine TBS, lumbar spine BMD and total hip BMD exceeding the 95% least significant change (LSC)
Methodological detailsindividual-level analysis
- Individual-level analysis
Main finding
As reported in the abstract
Change exceeding the LSC
Lumbar spine trabecular bone score (TBS): change exceeding least significant change (LSC) (9.3% increase, 13.8% decrease)
23.0%
Lumbar spine bone mineral density (BMD): change exceeding LSC (22.1% increase, 16.1% decrease)
38.2%
Total hip BMD: change exceeding LSC (17.6% increase, 24.9% decrease)
42.5%
Observational data: associations, not effects.
Further findings
Factors associated with significant TBS change
- Strongest associations (decreasing order): tissue thickness change, acquisition mode change, weight change, spine percent fat change
- Oral antiresorptive use showed very little effect on TBS change
- Regression models
Factors associated with spine and total hip BMD change
- Osteoporosis medication use was the most significant variable; tissue thickness change, acquisition mode change and weight change had relatively weak effects
- Regression models
Original publication
Contributions of Clinical and Technical Factors to Longitudinal Change in Trabecular Bone Score and Bone Density: A Registry-Based Individual-Level Analysis. J Bone Miner Res. Published 19 January 2023. doi:10.
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