Background: Trabecular Bone Score (TBS, Med-Imaps, France) is an index of bone microarchitectural texture extracted from antero-posterior spine DXA. In this cross-sectional analysis from two facilities in Ukraine and Spain, we have investigated the age-related changes of the lumbar vertebrae microarchitecture assessed by TBS in a cohort of Caucasian men and compare the results to TBS reference data for Caucasian women.
Methods: Subjects in the study were Ukrainian and Spanish men aged 40 and older with a BMD Z-score at spine L1-L4 within ±2SD. Individuals were excluded if they had fractures, were on any osteoporosis treatment and/or had any illness that would be expected to impact bone metabolism. All data have been obtained from GE-Lunar DXA devices (Prodigy and iDxa, Madison, WI, USA). Cross-calibration between the two centers was performed for TBS. TBS was evaluated at spine L1-L4 but also for all possible vertebrae combinations.
Results: A database of 368 men aged 40 to 90 years was created. TBS and BMD values at L1-L4 were poorly correlated with BMI (r=0.16 and 0.22). TBS was poorly correlated with weight (r=-0.1) and height (0.03) whereas higher correlations were obtained for BMD (r=0.3 and 0.2). TBS values obtained for all lumbar vertebral combinations decreased significantly with age (see figure below, at L1-L4 for men and women). There was a linear decline of 13.5% (~-1.75 T-score) in TBS at L1-L4 between 40 and 90 years of age in men whereas a decline of 16.7% (~-2.58 T-score) was observed in women (Dufour et al.,OI 2012). Conversely to women, there is no modification of TBS decline rate after 65 years in men.
Conclusion: This study established for the first time TBS age related curve in European men at lumbar spine. The decrease seen in lumbar TBS reflects age-related micro-architecture texture changes at spine. Within 40-65 age range, similar TBS decline was observed in both European Caucasian men and women (p=0.8). After 65, TBS decline rate is significantly higher for women than for men (p<0.01). This study confirms the need for using gender dedicated reference data.
Disclosure: The authors declared no competing interests.