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Comparison of trabecular bone score and hip structural analysis with FRAX® in postmenopausal women with type 2 diabetes mellitus

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Abstract

Purpose

To evaluate (a) the performance in predicting the presence of bone fractures of trabecular bone score (TBS) and hip structural analysis (HSA) in type 2 diabetic postmenopausal women compared to a control group and (b) the fracture prediction ability of TBS versus Fracture Risk Calculator (FRAX®) as well as whether TBS can improve the fracture prediction ability of FRAX® in diabetic women.

Methods

Eighty diabetic postmenopausal women were matched with 88 controls without major diseases for age and body mass index. The individual 10-year fracture risk was assessed by FRAX® tool for Europe–Italy; bone mineral density (BMD) at lumbar spine, femoral neck and total hip was evaluated through dual-energy X-ray absorptiometry; TBS measurements were taken using the same region of interest as the BMD measurements; HSA was performed at proximal femur with the HSA software.

Results

Regarding variables of interest, the only significant difference between diabetic and control groups was observed for the value of TBS (median value: 1.215; IQR 1.138–1.285 in controls vs. 1.173; IQR 1.082–1.217 in diabetic; p = 0.002). The prevalence of fractures in diabetic women was almost tripled than in controls (13.8 vs. 3.4 %; p = 0.02). The receiver operator characteristic curve analysis showed that TBS alone (AUC = 0.71) had no significantly lower discriminative power for fracture prediction in diabetic women than FRAX major adjusted for TBS (AUC = 0.74; p = 0.65).

Conclusion

In diabetic postmenopausal women TBS is an excellent tool in identifying fragility fractures.

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Acknowledgments

The authors thank Maria Cristina Castaldini and Stefania Ferrazzini for their meaningful contribution in data collection and processing. The study was supported by Local Research Project Grant from University of Ferrara.

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Authors and Affiliations

  1. Department of Morphology, Surgery and Experimental Medicine, Menopause and Osteoporosis Centre, University of Ferrara, Via Boschetto 29, Ferrara, Italy

    Gloria Bonaccorsi & Enrica Fila

  2. Graduate School in Diagnostic Radiology, University of Milan, Via Festa del Perdono 7, Milan, Italy

    Carmelo Messina

  3. Clinical Epidemiology Research Center, Medical School, University of Ferrara, Arcispedale S. Anna, Via Aldo Moro 8, Ferrara, Italy

    Elisa Maietti

  4. Bone Metabolic Unit, Division of Nuclear Medicine, Fondazione Irccs Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Fabio Massimo Ulivieri

  5. Maria Cecilia Hospital GVM Care and Research, Cotignola, RA, Italy

    Renata Caudarella

  6. Department of Morphology, Surgery and Experimental Medicine, Section of Obstetric and Gynaecology, University of Ferrara, Via Aldo Moro 8, 44124, Cona, Ferrara, Italy

    Pantaleo Greco

  7. Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71121, Foggia, Italy

    Giuseppe Guglielmi

  8. Department of Radiology, I.R.C.C.S. Casa Sollievo della Sofferenza, Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy

    Giuseppe Guglielmi

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  1. Gloria Bonaccorsi
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  2. Enrica Fila
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  3. Carmelo Messina
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  4. Elisa Maietti
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  5. Fabio Massimo Ulivieri
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  6. Renata Caudarella
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  8. Giuseppe Guglielmi
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Corresponding author

Correspondence to Giuseppe Guglielmi.

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The authors declare that there is no conflict of interest regarding the publication of this paper.

Statement of human and animal rights

The investigation was undertaken within the framework of a protocol approved by the Medical School Ethics Committee.

Informed consent

Participants in the cohorts included in this analysis provided informed consent at enrollment.

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Bonaccorsi, G., Fila, E., Messina, C. et al. Comparison of trabecular bone score and hip structural analysis with FRAX® in postmenopausal women with type 2 diabetes mellitus. Aging Clin Exp Res 29, 951–957 (2017). https://doi.org/10.1007/s40520-016-0634-2

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  • DOI: https://doi.org/10.1007/s40520-016-0634-2

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