Trabecular Bone Score Change Is Not Predicted by Bone Turnover: Short-term Sequential Follow-up

Area of Science:

• Bone biology and osteoporosis research.
• Medical imaging and diagnostics.
• Gerontology and aging research.

Background:

• Trabecular bone score (TBS) assesses vertebrae microarchitecture for fracture risk.
• The role of TBS in monitoring antiresorptive therapy remains unclear.
• The correlation between TBS changes and bone resorption markers is unknown.

Purpose of the Study:

• To investigate the relationship between longitudinal changes in TBS and C-terminal telopeptide (CTX) of type I collagen.
• To determine if TBS dynamics reflect bone resorption rates.

Main Methods:

• Retrospective analysis of 110 patients with dual bone mineral density (BMD) measurements.
• Patients categorized by TBS change (increment, decrement, unchanged) based on a 5.8% threshold.
• Statistical analysis included Kruskal-Wallis and Pearson's correlation to compare TBS, BMD, CTX, comorbidities, fractures, and medications.

Main Results:

• Most patients (74.5%) showed TBS changes below the least significant threshold.
• No significant differences in fracture incidence or medication exposure were found across TBS change categories.
• BMD change positively correlated with TBS change (r=0.225, P=0.018), while BMD decrease correlated with higher CTX (r=-0.335, P=0.004).
• Crucially, no correlation was observed between CTX and TBS changes.

Conclusions:

• Longitudinal changes in TBS do not correlate with bone resorption markers (CTX).
• The clinical interpretation and implications of TBS dynamics require further investigation.
• Current findings suggest TBS changes may not directly reflect bone turnover.