title: Comparison of trabecular bone score and hip structural analysis with FRAX®in postmenopausal women with type 2 diabetes mellitus.
abstract: OBJECTIVE
  To evaluate (a) the performance in predicting the presence of bone fractures of trabecular bone score (TBS) and hip structural analysis (HSA) in type 2 diabetic postmenopausal women compared to a control group and (b) the fracture prediction ability of TBS versus Fracture Risk Calculator (FRAX®) as well as whether TBS can improve the fracture prediction ability of FRAX®in diabetic women.
  
  
  METHODS
  Eighty diabetic postmenopausal women were matched with 88 controls without major diseases for age and body mass index. The individual 10-year fracture risk was assessed by FRAX®tool for Europe-Italy; bone mineral density (BMD) at lumbar spine, femoral neck and total hip was evaluated through dual-energy X-ray absorptiometry; TBS measurements were taken using the same region of interest as the BMD measurements; HSA was performed at proximal femur with the HSA software.
  
  
  RESULTS
  Regarding variables of interest, the only significant difference between diabetic and control groups was observed for the value of TBS (median value: 1.215; IQR 1.138-1.285 in controls vs. 1.173; IQR 1.082-1.217 in diabetic; p = 0.002). The prevalence of fractures in diabetic women was almost tripled than in controls (13.8 vs. 3.4 %; p = 0.02). The receiver operator characteristic curve analysis showed that TBS alone (AUC = 0.71) had no significantly lower discriminative power for fracture prediction in diabetic women than FRAX major adjusted for TBS (AUC = 0.74; p = 0.65).
  
  
  CONCLUSIONS
  In diabetic postmenopausal women TBS is an excellent tool in identifying fragility fractures.
authors.affiliation: Department of Morphology, Surgery and Experimental Medicine, Menopause and Osteoporosis Centre, University of Ferrara, Via Boschetto 29, Ferrara, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Bonaccorsi
authors.affiliation: Department of Morphology, Surgery and Experimental Medicine, Menopause and Osteoporosis Centre, University of Ferrara, Via Boschetto 29, Ferrara, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Fila
authors.affiliation: Graduate School in Diagnostic Radiology, University of Milan, Via Festa del Perdono 7, Milan, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Messina
authors.affiliation: Clinical Epidemiology Research Center, Medical School, University of Ferrara, Arcispedale S. Anna, Via Aldo Moro 8, Ferrara, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Maietti
authors.affiliation: Bone Metabolic Unit, Division of Nuclear Medicine, Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Fabio Massimo
authors.initials: FM
authors.lastname: Ulivieri
authors.affiliation: Maria Cecilia Hospital GVM Care and Research, Cotignola, RA, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: Caudarella
authors.affiliation: Department of Morphology, Surgery and Experimental Medicine, Section of Obstetric and Gynaecology, University of Ferrara, Via Aldo Moro 8, 44124, Cona, Ferrara, Italy.
authors.forename: Pantaleo
authors.initials: P
authors.lastname: Greco
authors.affiliation: Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71121, Foggia, Italy. giuseppe.guglielmi@unifg.it.|Department of Radiology, I.R.C.C.S. Casa Sollievo della Sofferenza, Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy. giuseppe.guglielmi@unifg.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guglielmi
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D000071556:Cancellous Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006615:Hip / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D017698:Postmenopause; D015995:Prevalence; D018570:Risk Assessment; D012680:Sensitivity and Specificity
keywords: FRAX; Fracture risk; HSA; Menopause; Osteoporosis; Trabecular bone score; Type 2 diabetes