One of the most recent and extensively studied determinants of fracture risk is trabecular bone score (TBS). TBS, which is assessed by lumbar spine dual-energy X-ray absorptiometry (DXA) imaging, provides information about the micro-architectural deterioration of bone tissue. Previous studies have shown that TBS predicts fracture in postmenopausal women and older men. TBS is currently used in conjunction with BMD values to enhance the predictive ability of the widely used Fracture Risk Assessment tool (FRAX), a calculator used to assess an individual's 10-year risk of major osteoporotic fracture.
In the largest such study to date, a team of international researchers have now validated the predictive ability of TBS using individual-level data of 17,809 men and women from 14 studies worldwide. They aimed to validate the contribution of TBS to fracture risk prediction, independent of FRAX, and to examine the impact of applying TBS adjustment to FRAX probabilities.
The study authors found that:
Co-author Professor John A Kanis, Emeritus Professor in Human Metabolism, University of Sheffield, stated, "The findings of this study support the use of TBS, not only as a standalone assessment of fracture risk but also, more importantly, as an independent contributor to a more global risk assessment that could permit its use alongside established risk assessment tools such as FRAX."
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Reference: McCloskey EV, Oden A, Harvey NC, Leslie WD, Hans D, Johansson H, Barkmann R, Boutroy S, Brown J, Chapurlat R, Elders PJM, Fujita Y, Glüer CC, Goltzman D, Iki M, Karlsson M , Kindmark A, Kotowicz M, Kurumatani N, Kwok T, Lamy O, Leung J, Lippuner K, Ljunggren O, Lorentzon M, Mellström D, Merlijn T, Oei L, Ohlsson C, Pasco JA, Rivadeneira F, Rosengren B, Sornay-Rendu E, Szulc P, Tamaki J, Kanis JA. A Meta-Analysis of Trabecular Bone Score in Fracture Risk Prediction and Its Relationship to FRAX. Journal of Bone and Mineral Research , DOI: 10.1002/jbmr.2734
http://onlinelibrary.wiley.com/doi/10.1002/jbmr.2734/abstract
About FRAX®
FRAX is a simple calculation tool that integrates clinical information in a quantitative manner to predict a 10-year probability of major osteoporotic fracture for both women and men in different countries. The tool, launched by the WHO Collaborating Centre for Metabolic Bone Diseases in 2008, was developed at the Centre for Metabolic Bone Diseases, University of Sheffield, UK. It assists primary health-care providers to better target people in need of intervention, improving the allocation of health-care resources towards patients most likely to benefit from treatment. The FRAX calculator is now available for 58 countries and in 32 languages.
FRAX can be accessed in a number of ways:
Journal of Bone and Mineral Research