title: Spinal Bone Texture Assessed by Trabecular Bone Score in Adolescent Girls With Anorexia Nervosa.
abstract: BACKGROUND
  Trabecular bone score (TBS) is a bone assessment tool that offers information beyond that afforded by dual-energy x-ray absorptiometry (DXA) bone mineral density (BMD) measurements. Adolescents with anorexia nervosa (AN) are known to exhibit compromised bone density and skeletal strength.
  
  
  OBJECTIVE
  This study aimed to determine TBS among adolescents with AN and evaluate the correlation with anthropometric, clinical and densitometric variables.
  
  
  METHODS
  Areal BMD spinal measures were analyzed for TBS. Findings were compared with clinical (height, weight, body mass index [BMI], age, pubertal development, 25-hydroxyvitamin D) and self-reported data (illness duration, amenorrhea, exercise, fracture, family history of osteoporosis, and antidepressant use), and BMD measures by DXA and peripheral quantitative computed tomography (pQCT).
  
  
  METHODS
  This was an urban adolescent program consisting of 57 females with AN, age 11-18 y.
  
  
  METHODS
  Interventions included DXA (absolute BMD and Z-score), pQCT (volumetric BMD [vBMD] and stress-strain index [SSI]), laboratory evaluation, and questionnaire administration.
  
  
  METHODS
  Main outcome measures included TBS, areal and vBMD, SSI, fracture history, disease duration.
  
  
  RESULTS
  The TBS of six participants (11%) showed degraded and 19 (33%) partially degraded microarchitecture. Spinal TBS was correlated (P < .05) with age, height, weight, BMI, pubertal stage, BMD, and body composition by DXA, and BMD and SSI by pQCT. TBS was not correlated with disease duration, fracture, vitamin D status, race, or ethnicity, and self-reported health data.
  
  
  CONCLUSIONS
  TBS showed evidence of degraded microarchitecture in over 40% of this study sample, and strongly correlated with anthropometric data and measures of BMD and skeletal strength. TBS is a novel tool that captures another dimension of bone health in adolescents with AN.
authors.affiliation: Division of Adolescent Medicine (A.A.D., J.M.O., C.M.G.), Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903; Clinical Research Center (H.A.F.), Boston Children's Hospital, Boston, Massachusetts 02115; and Division of Endocrinology (G.G.), Women and Infants Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903.
authors.forename: Abigail A
authors.initials: AA
authors.lastname: Donaldson
authors.affiliation: Division of Adolescent Medicine (A.A.D., J.M.O., C.M.G.), Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903; Clinical Research Center (H.A.F.), Boston Children's Hospital, Boston, Massachusetts 02115; and Division of Endocrinology (G.G.), Women and Infants Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903.
authors.forename: Henry A
authors.initials: HA
authors.lastname: Feldman
authors.affiliation: Division of Adolescent Medicine (A.A.D., J.M.O., C.M.G.), Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903; Clinical Research Center (H.A.F.), Boston Children's Hospital, Boston, Massachusetts 02115; and Division of Endocrinology (G.G.), Women and Infants Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: O'Donnell
authors.affiliation: Division of Adolescent Medicine (A.A.D., J.M.O., C.M.G.), Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903; Clinical Research Center (H.A.F.), Boston Children's Hospital, Boston, Massachusetts 02115; and Division of Endocrinology (G.G.), Women and Infants Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903.
authors.forename: Geetha
authors.initials: G
authors.lastname: Gopalakrishnan
authors.affiliation: Division of Adolescent Medicine (A.A.D., J.M.O., C.M.G.), Hasbro Children's Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903; Clinical Research Center (H.A.F.), Boston Children's Hospital, Boston, Massachusetts 02115; and Division of Endocrinology (G.G.), Women and Infants Hospital and Alpert Medical School of Brown University, Providence, Rhode Island 02903.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Gordon
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000856:Anorexia Nervosa / Q000000981:diagnostic imaging*; D015519:Bone Density / Q000502:physiology*; D002648:Child; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*