The utility of lumbar spine trabecular bone score and femoral neck bone mineral density for identifying asymptomatic vertebral fractures in well-compensated type 2 diabetic patients

V. V. Zhukouskaya, Cristina Eller-Vainicher, A. Gaudio, F. Privitera, E. Cairoli, F. M. Ulivieri, S. Palmieri, V. Morelli, V. Grancini, E. Orsi, B. Masserini, A. M. Spada, C. E. Fiore, I. Chiodini

Research output: Contribution to journalArticle

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Abstract

Summary: The objective of the study was to evaluate the usefulness of trabecular bone score (TBS) and bone mineral density (BMD) for identifying vertebral fractures (VFx) in well-compensated type 2 diabetic (T2D) patients. TBS and femoral neck BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients. Introduction: In T2D, the prevalence of VFx is increased, especially in poorly compensated and complicated diabetic patients. The possibility of predicting the fracture risk in T2D patients by measuring BMD and TBS, an indirect parameter of bone quality, is under debate. Therefore, the objective was to evaluate the usefulness of TBS and BMD for identifying VFx in well-compensated T2D patients. Methods: Ninety-nine T2D postmenopausal women in good metabolic control (glycosylated haemoglobin 6.8 ± 0.7 %) and 107 control subjects without T2D were evaluated. In all subjects, we evaluated the following: the BMD at the lumbar spine (LS) and the femoral neck (FN); the TBS by dual X-ray absorptiometry; and VFx by radiography. In T2D subjects, the presence of diabetic retinopathy, neuropathy, and nephropathy was evaluated. Results: T2D subjects had increased VFx prevalence (34.3 %) as compared to controls (18.7 %) (p = 0.01). T2D subjects presented higher BMD (LS −0.8 ± 1.44, FN −1.06 ± 1.08), as compared to controls (LS −1.39 ± 1.28, p = 0.002; FN −1.45 ± 0.91, p = 0.006, respectively). TBS was not different between diabetics and controls. In fractured T2D patients, LS-BMD, FN-BMD, and TBS were reduced (−1.2 ± 1.44; −1.44 ± 1.04; 1.072 ± 0.15) and the prevalence of retinopathy (15.4 %) was increased than in nonfractured T2D subjects (−0.59 ± 1.4, p = 0.035; −0.87 ± 1.05, p = 0.005; 1.159 ± 0.15, p = 0.006; 1.8 %, p = 0.04, respectively). The combination of TBS ≤1.130 and FN-BMD less than −1.0 had the best diagnostic accuracy for detecting T2D fractured patients (SP 73.8 %, SN 63.6 %, NPV 78.9 %, PPV 56.8 %). Conclusions: TBS and FN-BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients.

Original languageEnglish
Pages (from-to)49-56
Number of pages8
JournalOsteoporosis International
Volume27
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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Femur Neck
Bone Density
Spine
Bone and Bones
Cancellous Bone
Diabetic Neuropathies
Photon Absorptiometry
Glycosylated Hemoglobin A
Diabetic Nephropathies
Diabetic Retinopathy
Radiography

Keywords

  • Diabetes-related osteoporosis
  • Trabecular bone score
  • Vertebral fractures

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

The utility of lumbar spine trabecular bone score and femoral neck bone mineral density for identifying asymptomatic vertebral fractures in well-compensated type 2 diabetic patients. / Zhukouskaya, V. V.; Eller-Vainicher, Cristina; Gaudio, A.; Privitera, F.; Cairoli, E.; Ulivieri, F. M.; Palmieri, S.; Morelli, V.; Grancini, V.; Orsi, E.; Masserini, B.; Spada, A. M.; Fiore, C. E.; Chiodini, I.

In: Osteoporosis International, Vol. 27, No. 1, 01.01.2016, p. 49-56.

Research output: Contribution to journalArticle

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abstract = "Summary: The objective of the study was to evaluate the usefulness of trabecular bone score (TBS) and bone mineral density (BMD) for identifying vertebral fractures (VFx) in well-compensated type 2 diabetic (T2D) patients. TBS and femoral neck BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients. Introduction: In T2D, the prevalence of VFx is increased, especially in poorly compensated and complicated diabetic patients. The possibility of predicting the fracture risk in T2D patients by measuring BMD and TBS, an indirect parameter of bone quality, is under debate. Therefore, the objective was to evaluate the usefulness of TBS and BMD for identifying VFx in well-compensated T2D patients. Methods: Ninety-nine T2D postmenopausal women in good metabolic control (glycosylated haemoglobin 6.8 ± 0.7 {\%}) and 107 control subjects without T2D were evaluated. In all subjects, we evaluated the following: the BMD at the lumbar spine (LS) and the femoral neck (FN); the TBS by dual X-ray absorptiometry; and VFx by radiography. In T2D subjects, the presence of diabetic retinopathy, neuropathy, and nephropathy was evaluated. Results: T2D subjects had increased VFx prevalence (34.3 {\%}) as compared to controls (18.7 {\%}) (p = 0.01). T2D subjects presented higher BMD (LS −0.8 ± 1.44, FN −1.06 ± 1.08), as compared to controls (LS −1.39 ± 1.28, p = 0.002; FN −1.45 ± 0.91, p = 0.006, respectively). TBS was not different between diabetics and controls. In fractured T2D patients, LS-BMD, FN-BMD, and TBS were reduced (−1.2 ± 1.44; −1.44 ± 1.04; 1.072 ± 0.15) and the prevalence of retinopathy (15.4 {\%}) was increased than in nonfractured T2D subjects (−0.59 ± 1.4, p = 0.035; −0.87 ± 1.05, p = 0.005; 1.159 ± 0.15, p = 0.006; 1.8 {\%}, p = 0.04, respectively). The combination of TBS ≤1.130 and FN-BMD less than −1.0 had the best diagnostic accuracy for detecting T2D fractured patients (SP 73.8 {\%}, SN 63.6 {\%}, NPV 78.9 {\%}, PPV 56.8 {\%}). Conclusions: TBS and FN-BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients.",
keywords = "Diabetes-related osteoporosis, Trabecular bone score, Vertebral fractures",
author = "Zhukouskaya, {V. V.} and Cristina Eller-Vainicher and A. Gaudio and F. Privitera and E. Cairoli and Ulivieri, {F. M.} and S. Palmieri and V. Morelli and V. Grancini and E. Orsi and B. Masserini and Spada, {A. M.} and Fiore, {C. E.} and I. Chiodini",
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T1 - The utility of lumbar spine trabecular bone score and femoral neck bone mineral density for identifying asymptomatic vertebral fractures in well-compensated type 2 diabetic patients

AU - Zhukouskaya, V. V.

AU - Eller-Vainicher, Cristina

AU - Gaudio, A.

AU - Privitera, F.

AU - Cairoli, E.

AU - Ulivieri, F. M.

AU - Palmieri, S.

AU - Morelli, V.

AU - Grancini, V.

AU - Orsi, E.

AU - Masserini, B.

AU - Spada, A. M.

AU - Fiore, C. E.

AU - Chiodini, I.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Summary: The objective of the study was to evaluate the usefulness of trabecular bone score (TBS) and bone mineral density (BMD) for identifying vertebral fractures (VFx) in well-compensated type 2 diabetic (T2D) patients. TBS and femoral neck BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients. Introduction: In T2D, the prevalence of VFx is increased, especially in poorly compensated and complicated diabetic patients. The possibility of predicting the fracture risk in T2D patients by measuring BMD and TBS, an indirect parameter of bone quality, is under debate. Therefore, the objective was to evaluate the usefulness of TBS and BMD for identifying VFx in well-compensated T2D patients. Methods: Ninety-nine T2D postmenopausal women in good metabolic control (glycosylated haemoglobin 6.8 ± 0.7 %) and 107 control subjects without T2D were evaluated. In all subjects, we evaluated the following: the BMD at the lumbar spine (LS) and the femoral neck (FN); the TBS by dual X-ray absorptiometry; and VFx by radiography. In T2D subjects, the presence of diabetic retinopathy, neuropathy, and nephropathy was evaluated. Results: T2D subjects had increased VFx prevalence (34.3 %) as compared to controls (18.7 %) (p = 0.01). T2D subjects presented higher BMD (LS −0.8 ± 1.44, FN −1.06 ± 1.08), as compared to controls (LS −1.39 ± 1.28, p = 0.002; FN −1.45 ± 0.91, p = 0.006, respectively). TBS was not different between diabetics and controls. In fractured T2D patients, LS-BMD, FN-BMD, and TBS were reduced (−1.2 ± 1.44; −1.44 ± 1.04; 1.072 ± 0.15) and the prevalence of retinopathy (15.4 %) was increased than in nonfractured T2D subjects (−0.59 ± 1.4, p = 0.035; −0.87 ± 1.05, p = 0.005; 1.159 ± 0.15, p = 0.006; 1.8 %, p = 0.04, respectively). The combination of TBS ≤1.130 and FN-BMD less than −1.0 had the best diagnostic accuracy for detecting T2D fractured patients (SP 73.8 %, SN 63.6 %, NPV 78.9 %, PPV 56.8 %). Conclusions: TBS and FN-BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients.

AB - Summary: The objective of the study was to evaluate the usefulness of trabecular bone score (TBS) and bone mineral density (BMD) for identifying vertebral fractures (VFx) in well-compensated type 2 diabetic (T2D) patients. TBS and femoral neck BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients. Introduction: In T2D, the prevalence of VFx is increased, especially in poorly compensated and complicated diabetic patients. The possibility of predicting the fracture risk in T2D patients by measuring BMD and TBS, an indirect parameter of bone quality, is under debate. Therefore, the objective was to evaluate the usefulness of TBS and BMD for identifying VFx in well-compensated T2D patients. Methods: Ninety-nine T2D postmenopausal women in good metabolic control (glycosylated haemoglobin 6.8 ± 0.7 %) and 107 control subjects without T2D were evaluated. In all subjects, we evaluated the following: the BMD at the lumbar spine (LS) and the femoral neck (FN); the TBS by dual X-ray absorptiometry; and VFx by radiography. In T2D subjects, the presence of diabetic retinopathy, neuropathy, and nephropathy was evaluated. Results: T2D subjects had increased VFx prevalence (34.3 %) as compared to controls (18.7 %) (p = 0.01). T2D subjects presented higher BMD (LS −0.8 ± 1.44, FN −1.06 ± 1.08), as compared to controls (LS −1.39 ± 1.28, p = 0.002; FN −1.45 ± 0.91, p = 0.006, respectively). TBS was not different between diabetics and controls. In fractured T2D patients, LS-BMD, FN-BMD, and TBS were reduced (−1.2 ± 1.44; −1.44 ± 1.04; 1.072 ± 0.15) and the prevalence of retinopathy (15.4 %) was increased than in nonfractured T2D subjects (−0.59 ± 1.4, p = 0.035; −0.87 ± 1.05, p = 0.005; 1.159 ± 0.15, p = 0.006; 1.8 %, p = 0.04, respectively). The combination of TBS ≤1.130 and FN-BMD less than −1.0 had the best diagnostic accuracy for detecting T2D fractured patients (SP 73.8 %, SN 63.6 %, NPV 78.9 %, PPV 56.8 %). Conclusions: TBS and FN-BMD below certain cutoffs may be useful for identifying VFx in well-compensated T2D patients.

KW - Diabetes-related osteoporosis

KW - Trabecular bone score

KW - Vertebral fractures

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