Osteoporosis International

, Volume 28, Issue 3, pp 909–915 | Cite as

The lumbar spine age-related degenerative disease influences the BMD not the TBS: the Osteolaus cohort

  • I. Padlina
  • E. Gonzalez-Rodriguez
  • D. Hans
  • M. Metzger
  • D. Stoll
  • B. Aubry-Rozier
  • O. LamyEmail author
Original Article



We evaluated the influence of degenerative disease and fractured vertebra on lumbar spine bone mineral density (BMD) and trabecular bone score (TBS) in 1500 women aged 50–80 years. TBS was not affected by a degenerative disease. While BMD increases after 62.5 years, TBS continues to decline. TBS should play a leading role in lumbar spine evaluation.


After menopause, lumbar spine (LS) BMD and TBS values decrease. Degenerative disease (DD) increases with age and affect LS BMD. The aim of this study was to measure changes in LS BMD and TBS in women 50 to 80 years old, taking into account the impact of fractured vertebrae and DD.


LS BMD, TBS, and vertebral fracture assessment were evaluated in the OsteoLaus cohort (1500 women, 50–80 years old). The exams were analyzed following ISCD guidelines to identify vertebrae with fractures or DD (Vex).


1443 women were enrolled: mean age 66.7 ± 11.7 years, BMI 25.7 ± 4.4. LS BMD and TBS were weakly correlated (r2 = 0.16). The correlation (Vex excluded) between age and BMD was +0.03, between age and TBS −0.34. According to age group, LS BMD was 1.2 to 3.2% higher before excluding Vex (p < 0.001). TBS had an insignificant change of <1% after excluding Vex. LS BMD (Vex) decreased by 4.6% between 52.5 and 62.5 years, and increased by 2.6% between 62.5 and 77.5 years. TBS (Vex excluded) values decreased steadily with age with an overall loss of 8.99% between 52.5 and 77.5 years. Spine TBS, femoral neck, and total hip BMD gradually decreased with age, reaching one SD between the oldest and youngest group.


TBS is not affected by DD. While BMD increases after 62.5 years, TBS continues to decline. For lumbar spine evaluation, in view of its independence from DD, TBS should play a leading role in the diagnosis in complement to BMD.


BMD Degenerative disease Lumbar spine TBS Vertebral fracture 



This research could not have been possible without the generosity of the OsteoLaus Cohort participants and of the CoLaus initiators: Pr. Peter Vollenweider, Pr. Gérard Waeber, Pr. Martin Preisig, and Pr. Vincent Moser.

Compliance with ethical standards

Conflicts of interest

Didier Hans is co-owner of the TBS patent and has corresponding ownership shares. The corresponding author ensures that none of the other authors has any conflicts of interest.


  1. 1.
    Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141CrossRefPubMedGoogle Scholar
  2. 2.
    Miller PD, Siris ES, Barrett-Connor E et al (2002) Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res 17:2222–2230CrossRefPubMedGoogle Scholar
  3. 3.
    Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Pothuaud L, Barthe N, Krieg MA, Mehsen N, Carceller P, Hans D (2009) Evaluation of the potential use of trabecular bone score to complement bone mineral density in the diagnosis of osteoporosis: a preliminary spine bmd-matched, case-control study. J Clin Densitom 12:170–176CrossRefPubMedGoogle Scholar
  5. 5.
    Roux JP, Wegrzyn J, Boutroy S, Bouxsein ML, Hans D, Chapurlat R (2013) The predictive value of trabecular bone score (TBS) on whole lumbar vertebrae mechanics: an ex vivo study. Osteoporos Int 24:2455–2460CrossRefPubMedGoogle Scholar
  6. 6.
    Muschitz C, Kocijan R, Haschka J et al (2015) TBS reflects trabecular microarchitecture in premenopausal women and men with idiopathic osteoporosis and low-traumatic fractures. Bone 79:259–266CrossRefPubMedGoogle Scholar
  7. 7.
    Silva BC, Leslie WD, Resch H et al (2014) Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res 29:518–530CrossRefPubMedGoogle Scholar
  8. 8.
    Harvey NC, Glüer CC, Binkley N et al (2015) Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice. Bone 78:216–224CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Leslie WD, Johansson H, Kanis JA et al (2014) Lumbar spine texture enhances 10-year fracture probability assessment. Osteoporos Int 25:2271–2277CrossRefPubMedGoogle Scholar
  10. 10.
    McCloskey EV, Odén A, Harvey NC et al (2016) A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX. J Bone Miner Res 31:940–948CrossRefPubMedGoogle Scholar
  11. 11.
    Liu G, Peacock M, Eilam O, Dorulla G, Braunstein E, Johnston CC (1997) Effect of osteoarthritis in the lumbar spine and hip on bone mineral density and diagnosis of osteoporosis in elderly men and women. Osteoporos Int 7:564–569CrossRefPubMedGoogle Scholar
  12. 12.
    Vogt MT, Rubin DA, San Valentin R et al (1999) Degenerative lumbar listhesis and bone mineral density in elderly women: the study of osteoporotic fractures. Spine (Phila Pa 1976) 24:2536–2541CrossRefGoogle Scholar
  13. 13.
    Kolta S, Briot K, Fechtenbaum J et al (2014) TBS result is not affected by lumbar spine osteoarthritis. Osteoporos Int 25:1759–1764CrossRefPubMedGoogle Scholar
  14. 14.
    Dufour R, Winzenrieth R, Heraud A, Hans D, Mehsen N (2013) Generation and validation of a normative, age-specific reference curve for lumbar spine trabecular bone score (TBS) in French women. Osteoporos Int 24:2837–2846CrossRefPubMedGoogle Scholar
  15. 15.
    Hans D, Downs RW Jr, Duboeuf F et al (2006) Skeletal sites for osteoporosis diagnosis: the 2005 ISCD Official Positions. J Clin Densitom 9:15–21CrossRefPubMedGoogle Scholar
  16. 16.
    Firmann M, Mayor V, Marques Vidal P et al (2008) The CoLaus study: a population-based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome. BMC Cardiovasc Disord Mar 8:6. doi: 10.1186/1471-2261-8-6 CrossRefGoogle Scholar
  17. 17.
    Lamy O, Krieg M, Metzger M, Aubry-Rozier B, Stoll D, Hans D (2012) The OsteoLaus cohort study. Bone mineral density, micro-architecture estimation and vertebral fracture assessment extracted from a single DXA device in combination with clinical risk factors improve significantly the identification of women at high risk of fracture. Osteologie 2:77–82Google Scholar
  18. 18.
    Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148CrossRefPubMedGoogle Scholar
  19. 19.
    Rossouw JE, Anderson GL, Prentice RL et al (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288:321–333CrossRefPubMedGoogle Scholar
  20. 20.
    Haugen IK, Slatkowsky-Christensen B, Ørstavik R, Kvien TK (2007) Bone mineral density in patients with hand osteoarthritis compared to population controls and patients with rheumatoid arthritis. Ann Rheum Dis 66:1594–1598CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Ichchou L, Allali F, Rostom S et al (2010) Relationship between spine osteoarthritis, bone mineral density and bone turn over markers in postmenopausal women. BMC Womens Health 10:25. doi: 10.1186/1472-6874-10-25 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2016

Authors and Affiliations

  • I. Padlina
    • 1
  • E. Gonzalez-Rodriguez
    • 1
    • 2
  • D. Hans
    • 1
  • M. Metzger
    • 1
  • D. Stoll
    • 1
  • B. Aubry-Rozier
    • 1
  • O. Lamy
    • 1
    • 3
    Email author
  1. 1.Center of Bone DiseasesLausanne University HospitalLausanneSwitzerland
  2. 2.Service of Endocrinology, Diabetology and MetabolismLausanne University HospitalLausanneSwitzerland
  3. 3.Service of Internal MedicineLausanne University HospitalLausanneSwitzerland

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