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Assessing bone impairment in ankylosing spondylitis (AS) using the trabecular bone score (TBS) and high-resolution peripheral quantitative computed tomography (HR-pQCT).
Bone. 2019 05; 122:8-13.BONE

Abstract

OBJECTIVES

To compare bone quality using the trabecular bone score (TBS) and bone microarchitecture in the distal tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) in ankylosing spondylitis (AS) patients and healthy controls (HC).

METHODS

Areal bone mineral density (aBMD) and TBS (TBS iNsight software) were evaluated using DXA (Hologic, QDR 4500); while volumetric bone mineral density (vBMD) and bone microarchitecture were analyzed in the distal tibia using HR-pQCT (Scanco) in 73 male patients with AS and 52 age-matched HC.

RESULTS

AS patients were a mean 41.6 ± 7.9 years old and had a mean disease duration of 16.4 ± 8.6 y, with a mean mSASSS 25.6 ± 16.4. No difference was observed in lumbar spine aBMD in AS patients and HC (p = 0.112), but total hip BMD (p = 0.011) and TBS (p < 0.001) were lower in AS patients. In the distal tibia, reduced trabecular volumetric density [Tb.vBMD (p < 0.006)] and structural alterations - trabecular thickness (Tb.Th), p = 0.044 and trabecular separation (Tb.Sp), p = 0.039 - were observed in AS patients relative to controls. Further analysis comparing TBS < 1.310 and TBS ≥ 1.310 in AS patients revealed a higher mean body mass index [BMI] (p = 0.010), lower tibia cortical vBMD [Ct.vBMD] (p = 0.007), lower tibia cortical thickness [Ct.Th]: (p = 0.048) in the former group. On logistic regression analysis, BMI (OR = 1.27; 95%IC = 1.08-1.50, p = 0.005), (VF 4.65; 1.13-19.1, p = 0.033) and tibial Ct.vBMD (0.98; 0.97-1.00, p = 0.007) were associated with a lower TBS (<1.310).

CONCLUSIONS

The present study demonstrates that TBS and HR-pQCT imaging are important technologies evaluating bone impairment in AS patients. Moreover, in these patients vertebral fractures were associated with lower TBS.

Authors+Show Affiliations

Bone Metabolism Laboratory, Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, Brazil.Bone Metabolism Laboratory, Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, Brazil.Bone Metabolism Laboratory, Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, Brazil.Bone Metabolism Laboratory, Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, Brazil.Center of Bone diseases - Rheumatology Division, Bone & Joint Department, Lausanne University Hospital, Lausanne, Switzerland.Center of Bone diseases - Rheumatology Division, Bone & Joint Department, Lausanne University Hospital, Lausanne, Switzerland.Département de Médecine, Service de Rhumatologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Canada.Bone Metabolism Laboratory, Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, Brazil. Electronic address: rosa.pereira@hc.fm.usp.br.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30708186

Citation

Caparbo, Valeria F., et al. "Assessing Bone Impairment in Ankylosing Spondylitis (AS) Using the Trabecular Bone Score (TBS) and High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT)." Bone, vol. 122, 2019, pp. 8-13.
Caparbo VF, Furlam P, Saad CGS, et al. Assessing bone impairment in ankylosing spondylitis (AS) using the trabecular bone score (TBS) and high-resolution peripheral quantitative computed tomography (HR-pQCT). Bone. 2019;122:8-13.
Caparbo, V. F., Furlam, P., Saad, C. G. S., Alvarenga, J. C., Aubry-Rozier, B., Hans, D., de Brum-Fernandes, A. J., & Pereira, R. M. R. (2019). Assessing bone impairment in ankylosing spondylitis (AS) using the trabecular bone score (TBS) and high-resolution peripheral quantitative computed tomography (HR-pQCT). Bone, 122, 8-13. https://doi.org/10.1016/j.bone.2019.01.024
Caparbo VF, et al. Assessing Bone Impairment in Ankylosing Spondylitis (AS) Using the Trabecular Bone Score (TBS) and High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT). Bone. 2019;122:8-13. PubMed PMID: 30708186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessing bone impairment in ankylosing spondylitis (AS) using the trabecular bone score (TBS) and high-resolution peripheral quantitative computed tomography (HR-pQCT). AU - Caparbo,Valeria F, AU - Furlam,Pedro, AU - Saad,Carla G S, AU - Alvarenga,Jackeline C, AU - Aubry-Rozier,Berengère, AU - Hans,Didier, AU - de Brum-Fernandes,Artur J, AU - Pereira,Rosa M R, Y1 - 2019/01/29/ PY - 2018/12/07/received PY - 2019/01/19/revised PY - 2019/01/28/accepted PY - 2019/2/2/pubmed PY - 2020/6/11/medline PY - 2019/2/2/entrez KW - Ankylosing spondylitis KW - Bone density KW - DXA KW - HR-pQCT KW - Trabecular bone score KW - Vertebral fractures SP - 8 EP - 13 JF - Bone JO - Bone VL - 122 N2 - OBJECTIVES: To compare bone quality using the trabecular bone score (TBS) and bone microarchitecture in the distal tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) in ankylosing spondylitis (AS) patients and healthy controls (HC). METHODS: Areal bone mineral density (aBMD) and TBS (TBS iNsight software) were evaluated using DXA (Hologic, QDR 4500); while volumetric bone mineral density (vBMD) and bone microarchitecture were analyzed in the distal tibia using HR-pQCT (Scanco) in 73 male patients with AS and 52 age-matched HC. RESULTS: AS patients were a mean 41.6 ± 7.9 years old and had a mean disease duration of 16.4 ± 8.6 y, with a mean mSASSS 25.6 ± 16.4. No difference was observed in lumbar spine aBMD in AS patients and HC (p = 0.112), but total hip BMD (p = 0.011) and TBS (p < 0.001) were lower in AS patients. In the distal tibia, reduced trabecular volumetric density [Tb.vBMD (p < 0.006)] and structural alterations - trabecular thickness (Tb.Th), p = 0.044 and trabecular separation (Tb.Sp), p = 0.039 - were observed in AS patients relative to controls. Further analysis comparing TBS < 1.310 and TBS ≥ 1.310 in AS patients revealed a higher mean body mass index [BMI] (p = 0.010), lower tibia cortical vBMD [Ct.vBMD] (p = 0.007), lower tibia cortical thickness [Ct.Th]: (p = 0.048) in the former group. On logistic regression analysis, BMI (OR = 1.27; 95%IC = 1.08-1.50, p = 0.005), (VF 4.65; 1.13-19.1, p = 0.033) and tibial Ct.vBMD (0.98; 0.97-1.00, p = 0.007) were associated with a lower TBS (<1.310). CONCLUSIONS: The present study demonstrates that TBS and HR-pQCT imaging are important technologies evaluating bone impairment in AS patients. Moreover, in these patients vertebral fractures were associated with lower TBS. SN - 1873-2763 UR - https://www.unboundmedicine.com/medline/citation/30708186/Assessing_bone_impairment_in_ankylosing_spondylitis__AS__using_the_trabecular_bone_score__TBS__and_high_resolution_peripheral_quantitative_computed_tomography__HR_pQCT__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S8756-3282(19)30035-3 DB - PRIME DP - Unbound Medicine ER -