Fat Mass Does Not Increase the Precision Error of Trabecular Bone Score Measurements

Carmelo Messina, Ciriaco Buonomenna, Giorgia Menon, Sandro Magnani, Domenico Albano, Salvatore Gitto, Fabio Massimo Ulivieri, Luca Maria Sconfienza

Research output: Contribution to journalArticle

Abstract

Introduction: Trabecular bone score (TBS) is an indirect index of trabecular microarchitecture derived from lumbar spine dual-energy X-ray absorptiometry. Previous phantom study showed that an increase in soft tissue thickness does not affect TBS reproducibility. We investigated the effect of increasing body mass index (BMI) and waist circumference on TBS precision error on patients, compared to bone mineral density (BMD). Methodology: A population of postmenopausal Caucasian women was distributed in 3 different BMI (normal, overweight, and class I obesity), plus 2 further groups based on waist circumference diameter (≤88 cm and >88 cm, respectively). In vivo precision error was calculated on 30 consecutive subjects that were scanned 2 times, with patient repositioning, using the Hologic QDR-Discovery W densitometer. Coefficient of variation, percent least significant change, and reproducibility were calculated according to the International Society for Clinical Densitometry guidelines. Results: Ninety-five women aged 66 ± 10 (mean ± standard deviation) were included. No significant differences were found both for BMD and TBS precision errors, respectively, when comparing BMI groups and waist circumference groups. BMD reproducibility ranged from 95.9% (BMI > 30 kg/m2) to 97.5% (BMI < 25 kg/m2). TBS reproducibility ranged between 95.8% (BMI = 25–29.9 kg/m2, waist circumference > 88 cm) and 96.6% (BMI < 25 kg/m2). With the exception of obese group, a significant difference was found between BMD and TBS reproducibility, being that of TBS slightly lower than BMD. A significant decrease of TBS values was found between normal and obese subjects, as well as between waist circumference groups. Conclusions: TBS precision error is not affected by BMI and waist circumference differences. TBS reproducibility showed to be slightly lower than that of BMD, but this difference was mitigated in obese patients. A negative association was found between the amount of fat mass and TBS mean values.

Original languageEnglish
Pages (from-to)359-366
Number of pages7
JournalJournal of Clinical Densitometry
Volume22
Issue number3
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Fats
Bone Density
Body Mass Index
Waist Circumference
Cancellous Bone
Moving and Lifting Patients
Photon Absorptiometry
Spine
Obesity
Guidelines
Population

Keywords

  • Dual-energy X-ray absorptiometry
  • obesity
  • precision
  • reproducibility
  • Trabecular bone score

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Fat Mass Does Not Increase the Precision Error of Trabecular Bone Score Measurements. / Messina, Carmelo; Buonomenna, Ciriaco; Menon, Giorgia; Magnani, Sandro; Albano, Domenico; Gitto, Salvatore; Ulivieri, Fabio Massimo; Sconfienza, Luca Maria.

In: Journal of Clinical Densitometry, Vol. 22, No. 3, 01.01.2019, p. 359-366.

Research output: Contribution to journalArticle

Messina, Carmelo ; Buonomenna, Ciriaco ; Menon, Giorgia ; Magnani, Sandro ; Albano, Domenico ; Gitto, Salvatore ; Ulivieri, Fabio Massimo ; Sconfienza, Luca Maria. / Fat Mass Does Not Increase the Precision Error of Trabecular Bone Score Measurements. In: Journal of Clinical Densitometry. 2019 ; Vol. 22, No. 3. pp. 359-366.
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AU - Messina, Carmelo

AU - Buonomenna, Ciriaco

AU - Menon, Giorgia

AU - Magnani, Sandro

AU - Albano, Domenico

AU - Gitto, Salvatore

AU - Ulivieri, Fabio Massimo

AU - Sconfienza, Luca Maria

PY - 2019/1/1

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N2 - Introduction: Trabecular bone score (TBS) is an indirect index of trabecular microarchitecture derived from lumbar spine dual-energy X-ray absorptiometry. Previous phantom study showed that an increase in soft tissue thickness does not affect TBS reproducibility. We investigated the effect of increasing body mass index (BMI) and waist circumference on TBS precision error on patients, compared to bone mineral density (BMD). Methodology: A population of postmenopausal Caucasian women was distributed in 3 different BMI (normal, overweight, and class I obesity), plus 2 further groups based on waist circumference diameter (≤88 cm and >88 cm, respectively). In vivo precision error was calculated on 30 consecutive subjects that were scanned 2 times, with patient repositioning, using the Hologic QDR-Discovery W densitometer. Coefficient of variation, percent least significant change, and reproducibility were calculated according to the International Society for Clinical Densitometry guidelines. Results: Ninety-five women aged 66 ± 10 (mean ± standard deviation) were included. No significant differences were found both for BMD and TBS precision errors, respectively, when comparing BMI groups and waist circumference groups. BMD reproducibility ranged from 95.9% (BMI > 30 kg/m2) to 97.5% (BMI < 25 kg/m2). TBS reproducibility ranged between 95.8% (BMI = 25–29.9 kg/m2, waist circumference > 88 cm) and 96.6% (BMI < 25 kg/m2). With the exception of obese group, a significant difference was found between BMD and TBS reproducibility, being that of TBS slightly lower than BMD. A significant decrease of TBS values was found between normal and obese subjects, as well as between waist circumference groups. Conclusions: TBS precision error is not affected by BMI and waist circumference differences. TBS reproducibility showed to be slightly lower than that of BMD, but this difference was mitigated in obese patients. A negative association was found between the amount of fat mass and TBS mean values.

AB - Introduction: Trabecular bone score (TBS) is an indirect index of trabecular microarchitecture derived from lumbar spine dual-energy X-ray absorptiometry. Previous phantom study showed that an increase in soft tissue thickness does not affect TBS reproducibility. We investigated the effect of increasing body mass index (BMI) and waist circumference on TBS precision error on patients, compared to bone mineral density (BMD). Methodology: A population of postmenopausal Caucasian women was distributed in 3 different BMI (normal, overweight, and class I obesity), plus 2 further groups based on waist circumference diameter (≤88 cm and >88 cm, respectively). In vivo precision error was calculated on 30 consecutive subjects that were scanned 2 times, with patient repositioning, using the Hologic QDR-Discovery W densitometer. Coefficient of variation, percent least significant change, and reproducibility were calculated according to the International Society for Clinical Densitometry guidelines. Results: Ninety-five women aged 66 ± 10 (mean ± standard deviation) were included. No significant differences were found both for BMD and TBS precision errors, respectively, when comparing BMI groups and waist circumference groups. BMD reproducibility ranged from 95.9% (BMI > 30 kg/m2) to 97.5% (BMI < 25 kg/m2). TBS reproducibility ranged between 95.8% (BMI = 25–29.9 kg/m2, waist circumference > 88 cm) and 96.6% (BMI < 25 kg/m2). With the exception of obese group, a significant difference was found between BMD and TBS reproducibility, being that of TBS slightly lower than BMD. A significant decrease of TBS values was found between normal and obese subjects, as well as between waist circumference groups. Conclusions: TBS precision error is not affected by BMI and waist circumference differences. TBS reproducibility showed to be slightly lower than that of BMD, but this difference was mitigated in obese patients. A negative association was found between the amount of fat mass and TBS mean values.

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KW - Trabecular bone score

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