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Trabecular bone score and its association with Cobb angle kyphosis in older men: a cross-sectional study for the Osteoporotic Fractures in Men (MrOS) Study

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Abstract

Summary

Hyperkyphosis (HK), or accentuated forward spinal curvature, commonly affects older people, although its causes are not completely understood. We tested whether a measure of bone quality, trabecular bone score (TBS), is associated with HK in 1997 older men, and determined that men with degraded TBS were more likely to have HK.

Introduction

While vertebral fractures and low bone mineral density (BMD) contribute to kyphosis progression, it is unknown whether the trabecular bone score (TBS) may provide additional information on bone quality that could influence the degree of kyphosis. We hypothesized that degraded TBS would be associated with hyperkyphosis (HK) defined as a Cobb angle > 50°.

Methods

Using data from 1997 participants of the Osteoporotic Fractures in Men (MrOS) Study who had baseline TBS and Cobb angle kyphosis measured, we investigated whether men with degraded TBS were more likely to be hyperkyphotic, even after adjustment for BMD and prevalent vertebral fractures.

Results

Men were an average age of 74 ± 6 (mean ± SD) years with a mean kyphosis angle of 38.6 ± 11.5°, 295 (15%) were classified as hyperkyphotic, and 416 (21%) had degraded TBS. Compared with men with TBS > 1.2, men with degraded TBS were more likely to have HK (OR: 1.47, 95% CI: 1.06–2.06, p = 0.02) after adjusting for age, clinic, race, BMI, hip BMD, and prevalent vertebral fracture. If spine instead of hip BMD was included in the model, the odds ratio decreased to 1.35 (95% CI: 0.97–1.89, p = 0.08).

Conclusions

Older men with degraded TBS are more likely to have HK not explained by underlying vertebral fractures.

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Funding

This study is supported by the National Institute on Aging (NIA) under grant R01 AG024246. The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128.

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Authors and Affiliations

  1. Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    R. Patel

  2. Herbert Wertheim School of Public Health and Human Longevity Sciences, University of California San Diego, La Jolla, CA, USA

    J. Shen & J. F. Nichols

  3. Park Nicollet Clinic and Health Partners Institute and University of Minnesota, Minneapolis, MN, USA

    J. T. Schousboe

  4. Department of Medicine, University of California San Diego and VA San Diego Health Care System, La Jolla, CA, USA

    G. N. Woods

  5. University of California, San Francisco, San Francisco, CA, USA

    W. B. Katzman

  6. Department of Medicine, Stanford University, Stanford, California and VA Palo Alto, Palo Alto, CA, USA

    D. M. Kado

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  1. R. Patel
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  2. J. Shen
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  3. J. F. Nichols
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  4. J. T. Schousboe
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  5. G. N. Woods
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  6. W. B. Katzman
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  7. D. M. Kado
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Correspondence to D. M. Kado.

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Patel, R., Shen, J., Nichols, J.F. et al. Trabecular bone score and its association with Cobb angle kyphosis in older men: a cross-sectional study for the Osteoporotic Fractures in Men (MrOS) Study. Osteoporos Int 33, 1171–1176 (2022). https://doi.org/10.1007/s00198-021-06267-w

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  • DOI: https://doi.org/10.1007/s00198-021-06267-w

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