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A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX.

Författare och institution:
Eugene V McCloskey (-); Anders Odén (-); Nicholas C Harvey (-); William D Leslie (-); Didier Hans (-); Helena Johansson (-); Reinhard Barkmann (-); Stephanie Boutroy (-); Jacques Brown (-); Roland Chapurlat (-); Petra Jm Elders (-); Yuki Fujita (-); Claus-C Glüer (-); David Goltzman (-); Masayuki Iki (-); Magnus Karlsson (-); Andreas Kindmark (-); Mark Kotowicz (-); Norio Kurumatani (-); Timothy Kwok (-); Oliver Lamy (-); Jason Leung (-); Kurt Lippuner (-); Östen Ljunggren (-); Mattias Lorentzon (Centre for Bone and Arthritis Research & Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition); Dan Mellström (Centre for Bone and Arthritis Research & Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition); Thomas Merlijn (-); Ling Oei (-); Claes Ohlsson (Centre for Bone and Arthritis Research); Julie A Pasco (-); Fernando Rivadeneira (-); Björn Rosengren (-); Elisabeth Sornay-Rendu (-); Pawel Szulc (-); Junko Tamaki (-); John A Kanis (-)
Publicerad i:
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 31 ( 5 ) s. 940–948
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
Trabecular bone score (TBS) is a grey-level textural index of bone microarchitecture derived from lumbar spine dual-energy X-ray absorptiometry (DXA) images. TBS is a BMD-independent predictor of fracture risk. The objective of this meta-analysis was to determine whether TBS predicted fracture risk independently of FRAX probability and to examine their combined performance by adjusting the FRAX probability for TBS. We utilized individual level data from 17,809 men and women in 14 prospective population-based cohorts. Baseline evaluation included TBS and the FRAX risk variables and outcomes during follow up (mean 6.7 years) comprised major osteoporotic fractures. The association between TBS, FRAX probabilities and the risk of fracture was examined using an extension of the Poisson regression model in each cohort and for each sex and expressed as the gradient of risk (GR; hazard ratio per 1SD change in risk variable in direction of increased risk). FRAX probabilities were adjusted for TBS using an adjustment factor derived from an independent cohort (the Manitoba Bone Density Cohort). Overall, the GR of TBS for major osteoporotic fracture was 1.44 (95% CI: 1.35-1.53) when adjusted for age and time since baseline and was similar in men and women (p > 0.10). When additionally adjusted for FRAX 10-year probability of major osteoporotic fracture, TBS remained a significant, independent predictor for fracture (GR 1.32, 95%CI: 1.24-1.41). The adjustment of FRAX probability for TBS resulted in a small increase in the GR (1.76, 95%CI: 1.65, 1.87 vs. 1.70, 95%CI: 1.60-1.81). A smaller change in GR for hip fracture was observed (FRAX hip fracture probability GR 2.25 vs. 2.22). TBS is a significant predictor of fracture risk independently of FRAX. The findings support the use of TBS as a potential adjustment for FRAX probability, though the impact of the adjustment remains to be determined in the context of clinical assessment guidelines. This article is protected by copyright. All rights reserved.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Endokrinologi och diabetes ->
Postens nummer:
Posten skapad:
2015-12-21 13:24
Posten ändrad:
2016-07-04 10:23

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