Degraded microarchitecture by low trabecular bone score is associated with prevalent vertebral fractures in patients with systemic lupus erythematosus

Archives of Osteoporosis - Tập 15 - Trang 1-7 - 2020
Ee-Ling Lai1,2, Wen-Nan Huang2,3, Hsin-Hua Chen2,3,4,5,6,7, Jun-Peng Chen4, Der-Yuan Chen8,9, Tsu-Yi Hsieh2,10, Wei-Ting Hung2,10, Kuo-Lung Lai2, Ching-Tsai Lin2, Kuo-Tung Tang2, Yi-Ming Chen2,3,4,5,6,11, Yi-Hsing Chen2,3
1Rheumatology Unit, Department of Internal Medicine, Hospital Sultan Ismail, Johor Bahru, Malaysia
2Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
3Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
4Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
5Rong Hsing Research Center for Translational Medicine, Chung Hsing University, Taichung, Taiwan
6Translational Medicine, National Chung Hsing University, Taichung, Taiwan
7Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
8Rheumatology and Immunology Center, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
9College of Medicine, China Medical University, Taichung, Taiwan
10Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan
11Bioinformatics Section, National Institute of Neurological Disorder and Stroke, National Institutes of Health, Bethesda, USA

Tóm tắt

Recently, trabecular bone score (TBS) has emerged as an important supplementary assessment tool in osteoporosis diagnosis and management. The high incidence of fragility fracture within the non-osteoporotic range of bone mineral density (BMD), among systemic lupus erythematosus (SLE) patients, highlights the crucial role of bone microarchitecture in osteoporosis. This study aimed to evaluate whether TBS identified existing vertebral fractures (VF) more accurately than BMD in SLE patients. This study enrolled 147 SLE patients from the Asia Pacific Lupus Collaboration (APLC) cohort, who had BMD and TBS assessed from January 2018 until December 2018. Twenty-eight patients sustaining VF and risk factors associated with increased fracture occurrence were evaluated. Independent risk factors and diagnostic accuracy of VF were analyzed by logistic regression and ROC curve, respectively. The prevalence of vertebral fracture among SLE patients was 19%. BMD, T-score, TBS, and TBS T-score were significantly lower in the vertebral fracture group. TBS exhibited higher positive predictive value and negative predictive value than L spine and left femur BMD for vertebral fractures. Moreover, TBS had a higher diagnostic accuracy than densitometric measurements (area under curve, 0.811 vs. 0.737 and 0.605). Degraded microarchitecture by TBS was associated with prevalent vertebral fractures in SLE patients. Our result suggests that TBS can be a complementary tool for assessing vertebral fracture prevalence in this population.

Tài liệu tham khảo

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Archives of Osteoporosis

Tập 15

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