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The applicability of trabecular bone score for osteoporosis diagnosis in ankylosing spondylitis

  • Observational Research
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Abstract

Ankylosing spondylitis (AS) patients have a high risk of osteoporotic fractures. The aim of this study was to evaluate the usefulness of trabecular bone score (TBS) in assessing fracture risk in patients with AS. 67 patients meeting the ASAS classification criteria were enrolled in the study. Fracture risk for each patient was assessed based on a lumbar spine exam encompassing bone mineral density (BMD), and TBS through a dual-energy X-ray absorptiometry (DXA) exam. In addition, each patient had an X-ray taken of their lumbar and thoracic spine to determine the presence of syndesmophytes and bony bridges, as well as spinous process and vertebral body fractures. Moreover, each patient's medical history was analyzed for other osteoporotic fractures. A major osteoporosis fracture (MOF) was found in 11 (16%) patients in total, of which 7 (10%) were vertebral body fractures. The mean TBS in patients with MOF and no MOF were, respectively, 1.12 and 1.29 (p < 0.001). No significant differences were found in BMD scores between the two groups. Syndesmophytes and bony bridges occurred more frequently in patients with MOF (p = 0.02). Age of 50 or more (RR = 9.86, p = 0.002), TBS score ≤ 1.31 (RR = 2.07, p < 0.0001), and presence of syndesmophytes and bony bridges (RR = 2.14, p = 0.04) were considered a relative risk (RR) increasing factors. TBS is a markedly more sensitive method of identifying patients with a high fracture risk compared to BMD measurement in a DXA exam in patients with AS.

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Open data sharing statement

Primary data of the study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Clinic of Rheumatology and Connective Tissue Diseases, Jan Biziel University Hospital No 2, Bydgoszcz, Poland

    Paweł Żuchowski

  2. Department of Radiology, Jan Biziel University Hospital No 2, Bydgoszcz, Poland

    Marta Dura

  3. Collegium Medicum, Bydgoszcz, Poland

    Marta Dura

  4. Nasz Lekarz Przychodnie Medyczne, Toruń, Poland

    Daniel Jeka & Marzena Waszczak-Jeka

Authors
  1. Paweł Żuchowski
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  2. Marta Dura
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  3. Daniel Jeka
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  4. Marzena Waszczak-Jeka
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Contributions

PZ study design, data collection, statistical analysis, data interpretation, manuscript preparation, literature search. MD study design, data collection, data interpretation, manuscript preparation, literature search. DJ data collection, manuscript preparation, literature search. MW-J data interpretation, manuscript preparation, literature search.

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Correspondence to Paweł Żuchowski.

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Compliance with ethical standards

The study was approved by the bioethical commission: Uniwersytet Mikołaja Kopernika w Toruniu, Collegium Medicum im. L. Rydygiera w Bydgoszczy, Komisja Bioetyczna (study number: KB 771/2018, date of approval: 20/NOV/2018).

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Żuchowski, P., Dura, M., Jeka, D. et al. The applicability of trabecular bone score for osteoporosis diagnosis in ankylosing spondylitis. Rheumatol Int 42, 839–846 (2022). https://doi.org/10.1007/s00296-022-05109-0

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  • DOI: https://doi.org/10.1007/s00296-022-05109-0

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