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Osteologie 2012; 21(02): 77-82
DOI: 10.1055/s-0037-1621671
Original and review articles
Schattauer GmbH

The OsteoLaus Cohort Study

Bone mineral density, micro-architecture score and vertebral fracture assessment extracted from a single DXA device in combination with clinical risk factors improve significantly the identification of women at high risk of fractureDie OsteoLaus-KohortenstudieDie Kombination aus Knochenmineraldichte, Mikroarchitektur- Score und Wirbelfrakturerkennung, abgeleitet aus einer einzelnen DXA-Aufnahme, und klinischen Risikofaktoren verbessert deutlich die Identifizierung von Frauen mit hohem Frakturrisiko
O. Lamy
1   Centre for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
2   Service of internal medicine, Lausanne University Hospital, Lausanne, Switzerland
,
M. -A. Krieg
1   Centre for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
,
D. Stoll
1   Centre for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
,
B. Aubry-Rozier
1   Centre for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
3   Service of Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
,
M. Metzger
1   Centre for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
,
D. Hans
1   Centre for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
*   for the OsteoLaus Study
› Author Affiliations
Further Information

Publication History

received: 23 April 2012

accepted after revision: 29 May 2012

Publication Date:
04 January 2018 (online)

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Zusammenfassung

Eine indirekte Beurteilung der Mikroarchitektur (MA) ist in der täglichen Praxis anhand des TBS (Trabecular Bone Score) näherungsweise möglich. Das Ziel der OsteoLaus-Kohorte besteht darin, klinische Risikofaktoren und Informationen aus der DXA (Knochenmineraldichte [BMD], TBS und Wirbelkörperfrakturerkennung [VFA]) zu kombinieren, um Frauen mit hohem Frakturrisiko leichter zu erkennen. Wir nahmen 631 Frauen im mittleren Alter von 67,4 ± 6,7 J. und mit einem BMI von 26,1 ± 4,6 auf. Es bestand eine schwache Korrelation zwischen BMD und Zentrums-gematchtem TBS (r2 = 0,16). Die Prävalenz von Wirbelfrakturen (VFx) Grad 2/3, größeren osteoporotischen (OP) Frakturen und allen OP-Frakturen betrug 8,4 %, 17,0 % bzw. 26,0 %. Alters- und BMI-adjustierte OR (nach abnehmender SD) lagen bei 1,8 (1,2–2,5), 1,6 (1,2–2,1) bzw. 1,3 (1,1–1,6) für BMD und 2,0 (1,4–3,0), 1,9 (1,4–2,5) bzw. 1,4 (1,1–1,7) für TBS. Die TBS OR (nach abnehmender SD), adjustiert nach Alter, BMI und Wirbelsäulen-BMD, für VFx Grad 2/3, größere und alle OP-Frakturen betrugen 1,7 (1,1–2,7), 1,6 (1,2–2,2) bzw. 1,3 (1,0–1,7). Nur 35 bis 44 % der Frauen mit OP-Frakturen hatten eine BMD <−2,5 SD oder einen TBS < 1.200. Durch Kombination eines BMD < −2,5 SD oder TBS < 1,200 werden 54 bis 60 % der Frauen mit OP-Fraktur erkannt. Somit können wir anhand von VFA, BMD und TBS aus einem einfachen und strahlenarmen Röntgenverfahren, der DXA, Zusatzinformationen gewinnen, die für den Patienten im Praxisalltag von Nutzen sind.

Summary

Indirect micro-architectural (MA) approximation is evaluable in daily practice by the Trabecular Bone Score (TBS) measure. The aim of the OsteoLaus cohort is to combine CRF and the information given by DXA (bone mineral density [BMD], TBS and vertebral fracture assessment [VFA]) to better identify women at high fracture risk. We included 631 women: mean age 67.4 ± 6.7 y, BMI 26.1 ± 4.6. Correlation between BMD and site matched TBS was low (r2 = 0.16). Prevalence of vertebral fractures (VFx) grade 2/3, major OP Fx and all OP Fx was 8.4 %, 17.0 % and 26.0 % respectively. Age- and BMI-adjusted ORs (per SD decrease) were 1.8 (1.2–2.5), 1.6 (1.2–2.1), 1.3 (1.1–1.6) for BMD and 2.0 (1.4–3.0), 1.9 (1.4–2.5), 1.4 (1.1–1.7) for TBS respectively. The TBS ORs (per SD decrease) adjusted for age, BMI and spine BMD for VFx grade 2/3, major and all OP Fx were 1.7 (1.1–2.7),1.6 (1.2–2.2) and 1.3 (1.0–1.7) respectively. Only 35 to 44 % of women with OP Fx had a BMD < ∓2.5 SD or a TBS < 1.200. If we combine a BMD < ∓2.5 SD or a TBS < 1.200, 54 to 60 % of women with an OP Fx are identified. Therefore by using VFA, BMD, and TBS from a simple and low ionizing radiation device, the DXA, we can obtain additional informations which are useful for the patient in the daily practice.

Schlüsselwörter

TBS-Wert (Trabecular Bone Score) - Knochenmineraldichte - VFA (Vertebral Fracture Assessment) - DXA-Gerät - Osteoporose

Keywords

Trabecular Bone Score (TBS) - bone mineral density - vertebral fracture assessment - DXA device - osteoporosis
 

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