Can TBS reference values be a valid indicator for clinical vertebral fracture? A cross-sectional study

Area of Science:

• Osteoporosis Research
• Bone Health Assessment
• Radiology and Imaging

Background:

• Trabecular Bone Score (TBS) offers fracture risk information partially independent of bone mineral density (BMD).
• Lack of established TBS reference values complicates clinical interpretation.
• Clinical vertebral fracture (CVF) assessment requires improved diagnostic indicators.

Purpose of the Study:

• To evaluate the utility of TBS reference values as an indicator for clinical vertebral fracture (CVF).
• To determine if TBS can supplement BMD in identifying fracture risk.
• To establish TBS cut-off values for CVF across different BMD categories.

Main Methods:

• Cross-sectional study of 231 women with CVF and 563 controls (aged 60-90).
• Dual-energy X-ray absorptiometry used for BMD assessment and TBS calculation.
• Participants categorized into osteoporosis, osteopenia, and normal BMD groups.

Main Results:

• Low TBS (≤1.23) was significantly more prevalent in the CVF group (36.7%) compared to controls (10.7%).
• Higher prevalence of CVF observed in low TBS groups across all BMD categories, most notably in osteoporosis.
• TBS cut-off values for CVF incidence were determined: 1.224 (osteoporosis), 1.319 (osteopenia), and 1.322 (normal BMD).

Conclusions:

• The defined low TBS reference value (≤1.23) effectively indicates clinical vertebral fracture (CVF).
• TBS serves as a valuable indicator for CVF, especially in osteoporotic patients.
• Future inclusion of TBS reference values in official guidelines is recommended for improved clinical practice.