Pedro Paulo Martins Alvarenga1,2, Barbara Campolina Silva3,4,5, Mariana Picoli Diniz1, Milena Bellei Leite1, Caroline Alves Moreira da Silva1, Jessica de Cássia Mendes Eleutério1, Maria Marta Sarquis Soares2,6, John P Bilezikian7, Bruno Muzzi Camargos8. 1. School of Medicine, Centro Universitário de Belo Horizonte - UNI-BH, Belo Horizonte, Brazil. 2. Department of Medicine, Federal University of Minas Gerais - UFMG -, Belo Horizonte, Brazil. 3. School of Medicine, Centro Universitário de Belo Horizonte - UNI-BH, Belo Horizonte, Brazil. barbarasilva2131@gmail.com. 4. Division of Endocrinology, Hospital Felicio Rocho, Belo Horizonte, Brazil. barbarasilva2131@gmail.com. 5. Division of Endocrinology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil. barbarasilva2131@gmail.com. 6. Division of Endocrinology, Hospital Felicio Rocho, Belo Horizonte, Brazil. 7. Metabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA. 8. Centro de Densitometria Óssea/Hospital Mater Dei, Belo Horizonte, Brazil.
Abstract
PURPOSE: Areal bone mineral density (aBMD) by DXA is underestimated in those with smaller bones and overestimated in those with larger bones. Trabecular bone score (TBS) predicts fracture risk, and is not influenced by bone size. The aim of this study was to evaluate TBS and BMD in women with short stature. METHODS: We retrospectively analyzed DXA scans of all women aged 50-90 years with short stature (<144 cm) obtained in a single center, from 2006 to 2016. The comparison group comprised women >161 cm in height, matched for age and LS BMD, selected from the same database. RESULTS: The study population included 342 women. The two groups were similar in age, and aBMD at the LS and total hip. Femoral neck aBMD was lower in cases than in taller women. In contrast, TBS was higher in women with short stature than in their taller counterparts (1.347 ± 0.102 vs. 1.250 ± 0.110; p < 0.001). Bone mineral apparent density (BMAD) and the LS TBS-adjusted BMD T-score were also significantly higher in shorter than in taller women. From the entire cohort, 121 women (67 cases) were osteoporotic by aBMD determinations. Among these subjects, TBS was also greater in cases (1.303 ± 0.103) than in women with standard height (1.190 ± 0.099; p < 0.001). Despite being considered osteoporotic, 36% of short women, but none of the taller ones, had a normal TBS. CONCLUSIONS: TBS can be a useful adjunct to aBMD for assessing bone quality in short women, in whom aBMD measurement tends to read lower, and, thus could overestimate fracture risk.
PURPOSE: Areal bone mineral density (aBMD) by DXA is underestimated in those with smaller bones and overestimated in those with larger bones. Trabecular bone score (TBS) predicts fracture risk, and is not influenced by bone size. The aim of this study was to evaluate TBS and BMD in women with short stature. METHODS: We retrospectively analyzed DXA scans of all women aged 50-90 years with short stature (<144 cm) obtained in a single center, from 2006 to 2016. The comparison group comprised women >161 cm in height, matched for age and LS BMD, selected from the same database. RESULTS: The study population included 342 women. The two groups were similar in age, and aBMD at the LS and total hip. Femoral neck aBMD was lower in cases than in taller women. In contrast, TBS was higher in women with short stature than in their taller counterparts (1.347 ± 0.102 vs. 1.250 ± 0.110; p < 0.001). Bone mineral apparent density (BMAD) and the LS TBS-adjusted BMD T-score were also significantly higher in shorter than in taller women. From the entire cohort, 121 women (67 cases) were osteoporotic by aBMD determinations. Among these subjects, TBS was also greater in cases (1.303 ± 0.103) than in women with standard height (1.190 ± 0.099; p < 0.001). Despite being considered osteoporotic, 36% of short women, but none of the taller ones, had a normal TBS. CONCLUSIONS:TBS can be a useful adjunct to aBMD for assessing bone quality in short women, in whom aBMD measurement tends to read lower, and, thus could overestimate fracture risk.
Entities:
Keywords:
DXA; Fracture risk; Osteoporosis; Short stature; Trabecular bone score
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