Keywords :
Bone microarchitecture; End-stage renal disease (ESRD); High-resolution peripheral quantitative computed tomography (HR-pQCT); Trabecular bone score (TBS); Humans; Male; Female; Middle Aged; Aged; Adult; Tibia/diagnostic imaging; Radius/diagnostic imaging; Kidney Failure, Chronic/diagnostic imaging; Kidney Failure, Chronic/physiopathology; Cancellous Bone/diagnostic imaging; Bone Density; Absorptiometry, Photon; Tomography, X-Ray Computed; Orthopedics and Sports Medicine
Abstract :
[en] [en] RATIONALE: This study evaluates TBS for estimating bone microarchitecture in ESRD patients using HR-pQCT as the reference technique.
MAIN RESULTS: TBS correlates significantly with vBMD and bone microarchitecture, unlike aBMD.
SIGNIFICANCE: TBS may complement bone health assessment in ESRD patients by offering additional information alongside aBMD.
PURPOSE: Given the high fracture risk, non-invasive techniques for assessing bone fragility in chronic kidney disease (CKD) remain important. Trabecular bone score (TBS) may provide additional information that could help guide treatment and follow-up decisions. The aim of this study is to investigate whether TBS reflects bone microarchitecture in end-stage renal disease (ESRD) patients, using high-resolution peripheral quantitative computed tomography (HR-pQCT) as the reference technique. Additionally, we aim to identify parameters associated with a low TBS.
METHODS: Seventy-five ESRD patients were included at the time of kidney transplantation (KTx). Areal bone mineral density (aBMD) was analyzed using dual-energy X-ray absorptiometry (DXA). TBS was assessed from the L1-L4 area during DXA. Volumetric BMD (vBMD) and bone microarchitecture at tibia and radius sites were analyzed using HR-pQCT.
RESULTS: In ESRD patients, those with TBS < 1.370 were older and had a higher body mass index (BMI). In contrast to T-score-based classification (≤ -2.5 or > -2.5), low TBS was linked to significantly lower trabecular and cortical vBMD, reduced trabecular bone volume fraction (BV/TV) and trabecular number (Tb.N), and increased trabecular separation (Tb.Sp). In multivariate analysis, older age, higher BMI, and lower Tb.N remained independently associated with low TBS, while no HR-pQCT parameters were linked to low aBMD (T-score ≤ -2.5).
CONCLUSION: TBS correlates with both trabecular and cortical parameters measured by HR-pQCT, potentially offering a complementary perspective on bone microstructure compared to aBMD. At the time of KTx, a low TBS appears to better discriminate patients with significantly lower vBMD than aBMD alone.
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