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Changes in Trabecular Bone Score and Their Determinants in Young and Middle-aged Men: A Longitudinal Observational
Yaël Sertons1, Thiberiu Banica1, Stefan Goemaere1,2
1Department of Endocrinology, Ghent University Hospital & Department of Internal Medicine and Pediatrics, Ghent University, Ghent 9000, Belgium.
The Journal of Clinical Endocrinology and Metabolism
|August 16, 2025
Summary
Trabecular Bone Score (TBS) declines in healthy young men, even with normal bone turnover markers. Sex steroids like estradiol and free testosterone are linked to baseline TBS, but not its decline over time.
Area of Science:
- Bone biology and metabolism
- Endocrinology
- Osteoporosis research
Background:
- Trabecular Bone Score (TBS) assesses bone microarchitecture, a key factor in bone strength.
- Bone turnover markers (BTM) and sex steroids play roles in bone health.
- Understanding TBS changes in young men is crucial for early detection of bone loss.
Purpose of the Study:
- To investigate the relationship between bone turnover markers (BTM) and sex steroids with Trabecular Bone Score (TBS) in men.
- To analyze the longitudinal changes in TBS and their determinants in a cohort of healthy men.
Main Methods:
- A longitudinal, population-based study of 465 healthy men aged 25-45 years.
- Lumbar spine TBS was calculated using TBS iNsight® software.
- Sex steroids (testosterone, estradiol) and BTM were measured; statistical analyses used linear mixed-effects modeling.
Main Results:
- Baseline TBS was associated with free testosterone, free estradiol, and total estradiol, but not total testosterone or BTM.
- Over 12.5 years, TBS declined by 1.43%.
- Higher BMI and trunk fat predicted greater TBS decline, while sex steroids and BTM levels/changes did not correlate with TBS changes.
Conclusions:
- TBS decreases in young and middle-aged healthy men, indicating early changes in bone microarchitecture.
- While baseline sex steroid levels correlate with TBS, they do not predict its decline.
- Further research is needed to fully elucidate the mechanisms behind TBS changes in young men.
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