Association between pre-diabetes, type 2 diabetes and trabecular bone score: The Vietnam Osteoporosis Study

Ho‐Pham, Lan T.; Tran, Bich Huu; T., An; Nguyen, Tuan V.

doi:10.1016/j.diabres.2019.107790

Cited by 27 publications

(23 citation statements)

References 37 publications

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“…bone structure remained normal when HbA1c was lower than 7.5), fasting plasma glucose, and fasting insulin [59,60]. Currently, several studies conducted in more than 40,508 (4,269 diabetics) individuals altogether have robustly shown that TBS is lower in diabetics than in controls, whereas BMD is higher in diabetics than in controls [58][59][60][61][62][63][64][65][66][67][68][69][70]. Furthermore, TBS outperforms BMD in fracture discrimination and prediction in diabetics.…”

Section: Tbs and Diabetes Mellitusmentioning

confidence: 99%

DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

et al. 2021

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Osteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

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Section: Tbs and Diabetes Mellitusmentioning

confidence: 99%

DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

et al. 2021

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“…The Manitoba [32] study cohort had BMI of DM2 and non-DM2 patients around 29.7 vs 26.7 kg/m 2 , while another study from Korea [20] had average cohort ages between 62-66 years old with BMI of in women of 25.3 kg/m 2 (DM) vs 24.5 kg/m 2 (non-DM) and in men of 24.4 km/m 2 (DM) vs 23.5 kg/m 2 (non-DM). In the Vietnamese study the cohort average age was 60 years old in DM2 women with an average BMI of 25.0 kg/m 2 and 56 years old in DM2 men with an average BMI of 25.7 kg/m 2 [21]. Recent analyses have indicated that TBS is inversely related to BMI and abdominal fat, it may well be that our DM2 population of relatively lower BMI may not exhibit these effects in lowering TBS.…”

Section: Plos Onementioning

confidence: 97%

“…However, studies in different ethnic groups have shown varying results particularly with respect to gender and age [18,19]. In particular, TBS differences were found in studies in those younger than 65 years old [20,21] and were not seen in the older population [22].…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density and trabecular bone score in elderly type 2 diabetes Southeast Asian patients with severe osteoporotic hip fractures

et al. 2020

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Introduction Studies show trabecular bone score (TBS) may provide information regarding bone quality independent of bone mineral density (BMD) in type 2 diabetes (DM2) patients. We analyzed our Southeast Asian severe osteoporotic hip fracture patients to study these differences. Methods We conducted a retrospective cross-sectional analysis of subjects admitted to Changi General Hospital, Singapore with severe osteoporotic hip fractures from 2014–2017 who had BMD performed. Electronic records were reviewed and subjects were classified as having diabetes according to the WHO 2019 criteria. DM2 patients were classified according to their HbA1c into well controlled (HbA1c < 7%) and poorly controlled (HbA1c ≥ 7%) DM2. Results Elderly patients with hip fractures present with average femur neck T scores at the osteoporotic range, however those with DM2 had higher BMD and TBS values compared to non DM2 patients. These differences were statistically significant in elderly women—poorly controlled elderly DM2 women with hip fracture had the highest total hip T-score (-2.57 ± 0.86) vs (-2.76 ± 0.96) in well controlled DM2 and (-3.09 ± 1.01) in non DM2 women with hip fracture, p < 0.001. In contrast, TBS scores were lower in poorly controlled DM2 women with hip fracture compared to well controlled DM2 women with hip fracture (1.22 ± 0.11) vs (1.24 ± 0.09), but these were still significantly higher compared to non DM2 women with hip fracture (1.19 ± 0.10), p < 0.001. In elderly men with hip fractures, univariate analysis showed no statistically significant differences in TBS or hip or LS BMD between those with poorly controlled DM2, well controlled DM2 and non DM2. The differences in TBS and BMD remained significant in all DM2 women with hip fractures even after adjustments for potential confounders. Differences in TBS and BMD in poorly controlled DM2 men with hip fractures only became significant after accounting for potential confounders. However, upon inclusion of LS BMD into the multivariate model these differences were attenuated and remained significant only between elderly women with well controlled DM2 and non DM2 women with hip fractures. Conclusions Elderly patients with DM2 and severe osteoporosis present with hip fractures at a higher BMD and TBS values compared to non DM2 patients. These differences were significant after adjustment for confounders in all DM2 women and poorly controlled DM2 men with hip fractures, TBS differences were attenuated with the inclusion LS BMD. Further studies are needed to ascertain differences in BMD and TBS in older Southeast Asian DM2 patients with variable glycemic control and severe osteoporosis.

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“…TBS can be used as a complement to the BMD in fracture risk assessment [10][11][12] and is partially independent of BMD with different predicting factors. Different conditions including but not limited to glucocorticoid excess, primary hyperparathyroidism, higher free thyroid hormone, diabetes mellitus type 2, androgen-deficiency, chronic kidney disease, autoimmune disorders like rheumatoid arthritis and ankylosing spondylitis, obesity, and smoking are associated with a low TBS and increased fracture risk, independent of BMD [6,[13][14][15][16][17][18][19]. According to a large sample size cohort using Manitoba BMD Registry, the investigators evaluated the effect of TBS after a minimum of 5 years of observation in 37,176 subjects and they found that TBS could predict major osteoporotic fractures and/or hip fracture overall, and several of the considered clinical variables showed significant interactions with TBS.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with TBS worse than BMD in non-osteoporotic elderly population: Bushehr elderly health program

et al. 2021

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Background Bone mineral density (BMD) and trabecular bone score (TBS) are moderately correlated. TBS is sometimes used as an adjuvant to BMD in the fracture risk assessment. Some individuals with normal BMD or osteopenia, have more degraded TBS. We aimed to identify factors associated with TBS worse than BMD in the non-osteoporotic elderly population. Methods The study subjects were selected from 2384 women and men aged ≥60 years participating in the second stage of the Bushehr Elderly Health program, a population-based prospective cohort study in Iran. The BMDs of different sites and the lumbar spine texture were measured using dual-energy X-ray absorptiometry and the TBS algorithm, respectively. Subjects were categorized based on their BMD and TBS status. Logistic regression was performed to identify the factors associated with “TBS worse than BMD” in non-osteoporotic individuals. Results Of 1335 participants included in the study, 112 of 457 women, and 54 of 878 men had worse TBS than BMD. In multivariable analysis, TBS worse than BMD in women was statistically significantly associated with years since menopause (OR: 1.04 (1.00–1.07)) and waist circumference (OR: 1.09 (1.05–1.14)). However, in men, the condition was statistically significantly associated with waist circumference (OR: 1.10 (1.03–1.17)), current smoking (OR: 2.54 (1.10–5.84)), and HDL-C (OR: 1.03 (1.00–1.06)). Conclusion The results of the study show that higher waist circumference is associated with more degraded TBS than BMD in both men and women. Years passed since menopause and current smoking, respectively in women and men, were associated with more degraded TBS. Considering TBS values in older individuals with higher waist circumference, or a history of smoking despite normal BMDs might help more accurate assessment of bone health. However, further studies are required to confirm the benefit.

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Association between pre-diabetes, type 2 diabetes and trabecular bone score: The Vietnam Osteoporosis Study

Cited by 27 publications

References 37 publications

DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Bone mineral density and trabecular bone score in elderly type 2 diabetes Southeast Asian patients with severe osteoporotic hip fractures

Factors associated with TBS worse than BMD in non-osteoporotic elderly population: Bushehr elderly health program

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