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

McCloskey, Eugene V., Odén, Anders, Harvey, Nicholas C., Leslie, William D., Hans, Didier, Johansson, Helena, Barkmann, Reinhard, Boutroy, Stephanie, Brown, Jacques, Chapurlat, Roland, Elders, Petra J. M., Fujita, Yuki, Glüer, Claus-C., Goltzman, David, Iki, Masayuki, Karlsson, Magnus, Kindmark, Andrea, Kotowicz, Mark, Kurumatani, Norio, Kwok, Timothy, Lamy, Oliver, Leung, Jason, Lippuner, Kurt, Ljunggren, Östen, Lorentzon, Mattias, Mellström, Dan, Merlijn, Thomas, Oei, Ling, Ohlsson, Claes, Pasco, Julie A., Rivadeneira, Fernando, Rosengren, Björn, Sornay-Rendu, Elisabeth, Szulc, Pawel, Tamaki, Junko and Kanis, John A. 2016, A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX, Journal of bone and mineral research, vol. 31, no. 5, pp. 940-948, doi: 10.1002/jbmr.2734.

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Title A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX
Author(s) McCloskey, Eugene V.
Odén, Anders
Harvey, Nicholas C.
Leslie, William D.
Hans, Didier
Johansson, Helena
Barkmann, Reinhard
Boutroy, Stephanie
Brown, Jacques
Chapurlat, Roland
Elders, Petra J. M.
Fujita, Yuki
Glüer, Claus-C.
Goltzman, David
Iki, Masayuki
Karlsson, Magnus
Kindmark, Andrea
Kotowicz, MarkORCID iD for Kotowicz, Mark orcid.org/0000-0002-8094-1411
Kurumatani, Norio
Kwok, Timothy
Lamy, Oliver
Leung, Jason
Lippuner, Kurt
Ljunggren, Östen
Lorentzon, Mattias
Mellström, Dan
Merlijn, Thomas
Oei, Ling
Ohlsson, Claes
Pasco, Julie A.ORCID iD for Pasco, Julie A. orcid.org/0000-0002-8968-4714
Rivadeneira, Fernando
Rosengren, Björn
Sornay-Rendu, Elisabeth
Szulc, Pawel
Tamaki, Junko
Kanis, John A.
Journal name Journal of bone and mineral research
Volume number 31
Issue number 5
Start page 940
End page 948
Total pages 9
Publisher Wiley
Place of publication London, Eng.
Publication date 2016-05
ISSN 1523-4681
Keyword(s) FRAX
TBS
Trabecular bone structure
fracture
meta-analysis
risk
Summary 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.
Language eng
DOI 10.1002/jbmr.2734
Field of Research 110314 Orthopaedics
Socio Economic Objective 920116 Skeletal System and Disorders (incl. Arthritis)
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, American Society for Bone and Mineral Research
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080417

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.