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<i>Summary</i> <p><b>Rationale</b>: This study evaluates TBS for estimating bone microarchitecture in ESRD patients using HR-pQCT as the reference technique. <b>Main results</b>: TBS correlates significantly with vBMD and bone microarchitecture, unlike aBMD. <b>Significance</b>: TBS may complement bone health assessment in ESRD patients by offering additional information alongside aBMD.</p> Purpose <p>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.</p> Methods <p>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.</p> Results <p>In ESRD patients, those with TBS &lt; 1.370 were older and had a higher body mass index (BMI). In contrast to T-score-based classification (≤ -2.5 or &gt; -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).</p> Conclusion <p>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.</p>

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Trabecular bone score to assess bone microarchitecture in end-stage renal disease patients

  • 期刊论文

  • 发表日期：

    2025年3月7日

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  • Antoine Bouquegneau,
  • François Jouret,
  • Laurence Seidel,
  • Catherine Bonvoisin,
  • Laurent Weekers,
  • Clio Ribbens,
  • Olivier Bruyere,
  • Etienne Cavalier,
  • Pierre Delanaye,
  • Olivier Malaise

摘要

Summary

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.