title: Trabecular Bone Score Reflects Trabecular Microarchitecture Deterioration and Fragility Fracture in Female Adult Patients Receiving Glucocorticoid Therapy: A Pre-Post Controlled Study.
abstract: A recently developed diagnostic tool, trabecular bone score (TBS), can provide quality of trabecular microarchitecture based on images obtained from dual-energy X-ray absorptiometry (DXA). Since patients receiving glucocorticoid are at a higher risk of developing secondary osteoporosis, assessment of bone microarchitecture may be used to evaluate risk of fragility fractures of osteoporosis. In this pre-post study of female patients, TBS and fracture risk assessment tool (FRAX) adjusted with TBS (T-FRAX) were evaluated along with bone mineral density (BMD) and FRAX. Medical records of patients with (n= 30) and without (n= 16) glucocorticoid treatment were retrospectively reviewed. All patients had undergone DXA twice within a 12- to 24-month interval. Analysis of covariance was conducted to compare the outcomes between the two groups of patients, adjusting for age and baseline values. Results showed that a significant lower adjusted mean of TBS (p= 0.035) and a significant higher adjusted mean of T-FRAX for major osteoporotic fracture (p= 0.006) were observed in the glucocorticoid group. Conversely, no significant differences were observed in the adjusted means for BMD and FRAX. These findings suggested that TBS and T-FRAX could be used as an adjunct in the evaluation of risk of fragility fractures in patients receiving glucocorticoid therapy.
authors.affiliation: Department of Pharmacy, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.
authors.forename: Mei-Hua
authors.identifier: 0000-0002-0649-9709
authors.initials: MH
authors.lastname: Chuang
authors.affiliation: Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien City, Taiwan.
authors.forename: Tzyy-Ling
authors.identifier: 0000-0001-6325-046X
authors.initials: TL
authors.lastname: Chuang
authors.affiliation: Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Malcolm
authors.identifier: 0000-0002-9242-9167
authors.initials: M
authors.lastname: Koo
authors.affiliation: Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien City, Taiwan.
authors.forename: Yuh-Feng
authors.identifier: 0000-0002-0403-0536
authors.initials: YF
authors.lastname: Wang
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000187:drug effects; D000071556:Cancellous Bone / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D005938:Glucocorticoids