title: Bone mineral density (BMD) and vertebral trabecular bone score (TBS) for the identification of elderly women at high risk for fracture: the SEMOF cohort study.
abstract: To determine the predictive value of the vertebral trabecular bone score (TBS) alone or in addition to bone mineral density (BMD) with regard to fracture risk.
  
  
  
  Retrospective analysis of the relative contribution of BMD [measured at the femoral neck (FN), total hip (TH), and lumbar spine (LS)] and TBS with regard to the risk of incident clinical fractures in a representative cohort of elderly post-menopausal women previously participating in the Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk study.
  
  
  
  Complete datasets were available for 556 of 701 women (79 %). Mean age 76.1 years, LS BMD 0.863 g/cm2, and TBS 1.195. LS BMD and LS TBS were moderately correlated (r2= 0.25). After a mean of 2.7 ± 0.8 years of follow-up, the incidence of fragility fractures was 9.4 %. Age- and BMI-adjusted hazard ratios per standard deviation decrease (95 % confidence intervals) were 1.58 (1.16-2.16), 1.77 (1.31-2.39), and 1.59 (1.21-2.09) for LS, FN, and TH BMD, respectively, and 2.01 (1.54-2.63) for TBS. Whereas 58 and 60 % of fragility fractures occurred in women with BMD T score ≤-2.5 and a TBS <1.150, respectively, combining these two thresholds identified 77 % of all women with an osteoporotic fracture.
  
  
  
  Lumbar spine TBS alone or in combination with BMD predicted incident clinical fracture risk in a representative population-based sample of elderly post-menopausal women.
authors.affiliation: Department of Osteoporosis, University Hospital and University of Bern, 3010, Bern, Switzerland.
authors.forename: Albrecht W
authors.initials: AW
authors.lastname: Popp
authors.affiliation: Department of Osteoporosis, University Hospital and University of Bern, 3010, Bern, Switzerland.
authors.forename: Salome
authors.initials: S
authors.lastname: Meer
authors.affiliation: Department of Musculoskeletal Medicine, Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Krieg
authors.affiliation: Department of Osteoporosis, University Hospital and University of Bern, 3010, Bern, Switzerland.
authors.forename: Romain
authors.initials: R
authors.lastname: Perrelet
authors.affiliation: Department of Musculoskeletal Medicine, Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Didier
authors.initials: D
authors.lastname: Hans
authors.affiliation: Department of Osteoporosis, University Hospital and University of Bern, 3010, Bern, Switzerland. kurt.lippuner@insel.ch.
authors.forename: Kurt
authors.initials: K
authors.lastname: Lippuner
mesh_terms: D000368:Aged; D015519:Bone Density / Q000502:physiology*; D000071556:Cancellous Bone / Q000473:pathology*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D010024:Osteoporosis / Q000473:pathology*; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Bone mineral density; Fracture risk; Osteoporosis; Trabecular bone score