Journal of Bone Metabolism

"Trabecular bone"

Original Articles

The Fracture Risk Assessment Tool Probability and Trabecular Bone Score Mediate the Relationship between Sphingosine 1-phosphate Levels and Fracture Risk: Seung Hun Lee, Jae Seung Kim, Jung-Min Koh; J Bone Metab 2023;30(4):355-364.
Published online November 30, 2023; DOI: https://doi.org/10.11005/jbm.2023.30.4.355

Background
The sphingosine 1-phosphate (S1P) concentration is a potential biomarker of osteoporotic fracture and is associated with both the fracture risk assessment tool (FRAX) probability and trabecular bone score (TBS), which are well-known predictors of fracture. We sought to estimate the effect of the S1P concentration on fracture risk using the FRAX probability and TBS as mediators.
Methods
Plasma S1P concentrations, FRAX variables, and TBSs were measured in 66 postmenopausal women with fractures and 273 postmenopausal women without fractures. Associations between S1P concentration, FRAX probability, TBS, and fracture risk were analyzed using correlation, logistic regression, and mediation analyses.
Results
Subjects in the highest S1P concentration tertile had a higher fracture risk (odds ratio [OR], 5.09; 95% confidence interval [CI], 2.22–11.67) than those in the lowest S1P concentration tertile before adjustment. Subjects in the highest FRAX probability tertile had a higher fracture risk (OR, 14.59; 95% CI, 5.01–42.53) than those in the lowest FRAX probability tertile before adjustment. Subjects in the lowest TBS tertile had a higher fracture risk (OR, 4.76; 95% CI, 2.28–9.93) than those in the highest TBS tertile before adjustment. After adjustment for FRAX probability and TBS, the highest S1P concentration tertile was still associated with a higher fracture risk (OR, 3.13; 95% CI, 1.28–7.66). The FRAX probability and TBS accounted for 32.6% and 21.7%, respectively, of the relationship between the S1P concentration and fracture risk.
Conclusions
The relationship between the circulating S1P concentration and fracture risk was partly mediated by the FRAX probability, bone microarchitecture, and other factors.

Citations

Citations to this article as recorded by

1. Trabecular Bone Score: From Over a Decade of Evidence to a Connected Bone Health Ecosystem
Karen Hind, Madeleine Davies, Elena Gonzalez-Rodriguez, Didier Hans
Osteologie.2025; 34(03): 213. CrossRef
2. Novel aspects of biochemical assessment of bone remodeling and mineralization
Dorota Leszczyńska, Alicja Szatko, Agata Toboła, Katarzyna Karoń, Waldemar Misiorowski, Piotr Glinicki, Wojciech Zgliczyński
Frontiers in Endocrinology.2025;[Epub] CrossRef
3. The Effects and Risk Factors of Femoral Neck Shortening after Internal Fixation of Femoral Neck Fractures
Dae Hee Lee, Joo Han Kwon, Ki-Choul Kim
Clinics in Orthopedic Surgery.2024; 16(5): 718. CrossRef

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Trabecular Bone Score Could Not Predict the Bone Mineral Density of Proximal Humerus: Hyeon Jang Jeong, Joong Mo Ahn, Joo Han Oh; J Bone Metab 2021;28(3):239-247.
Published online August 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.3.239

Background
Osteoporosis is an important clinical factor for tendon healing after arthroscopic rotator cuff repair (ARCR). Conventional dual energy X-ray absorptiometry (DXA) of the hip and lumbar spine (LS) does not represent proximal humeral bone mineral density (BMD). Theoretically, direct measurement of the BMD of the proximal humerus is the best method; however, it is not popular and is non-standardized. Therefore, we evaluate whether the trabecular bone score (TBS) using LS DXA would represent proximal humeral BMD.
Methods
Conventional hip and LS DXA and proximal humeral BMD were measured in 212 consecutive ARCR patients, and TBS was calculated using LS DXA. Comparative analysis between the affected and contralateral asymptomatic shoulders was done; moreover, correlation analysis was conducted to evaluate the representativity of TBS for proximal humeral BMD. Regression analysis was performed to elucidate the risk factor of intraoperative suture anchor failure (ISAF).
Results
BMDs of the affected shoulder were significantly lower than those of the contralateral side (all P<0.05). TBS failed to present a strong correlation with proximal humeral BMD (correlation coefficients 0.155-0.506, all P<0.05), and the BMD of the greater tuberosity (GT) of the proximal humerus was revealed to be a sole risk factor for ISAF (odds ratio, 0.01, P=0.020).
Conclusions
TBS and conventional hip and LS DXA did not represent proximal humeral BMD. Furthermore, among the various radiological measurements, the BMD of the GT was a sole risk factor of ISAF. Therefore, further research for the direct measurement of proximal humeral BMD is mandatory to predict proximal humeral focal osteoporosis.

Citations

Citations to this article as recorded by

1. Preliminary evaluation of the clinical efficacy of salmon calcitonin nasal spray in patients with rotator cuff tears after arthroscopic repair: a multi-center retrospective cohort study
Fei Lyu, Dai Shi, Kapil Sugand, Xingguang Tao, Jianhong Wu, Zheng Xu, Huixiang Wang
International Journal of Surgery.2026; 112(5): 11062. CrossRef
2. Deltoid tuberosity index for proximal humerus fracture: reliability and a predictor of systemic osteoporosis in an Asian population
Wei Xiang Ng, Sanchalika Acharyya, Shirong Huang, Ernest Beng Kee Kwek, Bryan Yijia Tan
Journal of Shoulder and Elbow Surgery.2025; 34(3): e133. CrossRef
3. Age- and sex-related changes in proximal humeral volumetric BMD assessed via chest CT with a deep learning–based segmentation model
Shihuai Li, Chong Tang, Hongda Zhang, Chi Ma, Yuanzhi Weng, Bo Chen, Shenghao Xu, Hao Xu, Fausto Giunchiglia, Weijia William Lu, Deming Guo, Yanguo Qin
Osteoporosis International.2025; 36(11): 2185. CrossRef
4. Management of Rotator Cuff Tears in Severely Osteoporotic Patients
Devin A. Maez, Bryan A. Marquez, Christopher L. Shultz, Sheila N. Acheson, Dustin L. Richter
JBJS Journal of Orthopaedics for Physician Assistants.2024; 12(4): e24.00022. CrossRef
5. Arthroscopic transosseous anchorless rotator cuff repair reduces bone defects related to peri-implant cyst formation: a comparison with conventional suture anchors using propensity score matching
Hyeon Jang Jeong, Ji Soo Lee, Young Kyu Kim, Sung-Min Rhee, Joo Han Oh
Clinics in Shoulder and Elbow.2023; 26(3): 276. CrossRef

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The Characteristics of Women with Subsequent Distal Radius Fracture after Initial Distal Radius Fracture: Jongjin Lee, Jae Kwang Kim, Minyoung Oh, Young Ho Shin; J Bone Metab 2021;28(2):123-129.
Published online May 31, 2021; DOI: https://doi.org/10.11005/jbm.2021.28.2.123

Background
The purpose of this study was to investigate the characteristics of women with subsequent distal radius fracture (DRF) and to compare bone fragility variables in women with initial and subsequent DRF.
Methods
We enrolled 227 women who experienced DRF (203 women with initial DRF and 24 women with subsequent DRF) between September 2016 and April 2019. We compared demographic characteristics and bone fragility variables, including bone mineral density, trabecular bone score, hip geometry, bicortical thickness of the distal radius, and fracture risk assessment tool (FRAX) scores between the 2 groups. To reduce bias, patients with subsequent DRF were propensity score-matched in a 1:2 manner with patients affected by initial DRF, and additional comparisons were performed.
Results
Patients in the subsequent DRF group were older than those in the initial DRF group, but this difference was not significant (P=0.091). The proportion of patients receiving treatment with osteoporosis medication was significantly higher in the subsequent DRF group (41.7% vs. 19.2%, P=0.011). Bone fragility variables did not differ significantly between the 2 groups. However, the ten-year probability of major osteoporotic fractures based on FRAX scores was significantly higher in patients with subsequent DRF (7.5% vs. 10.8%, P<0.001). Similar results were observed when comparing the propensity score-matched initial and subsequent DRF groups.
Conclusions
These findings suggest that the occurrence of subsequent DRF after initial DRF can be attributed to multiple factors rather than bone fragility alone. Systematic and multidisciplinary management would be helpful in preventing the occurrence of subsequent DRF after the initial DRF.

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Longitudinal Change in Trabecular Bone Score during and after Treatment of Osteoporosis in Postmenopausal Korean Women: Mi-Seon Shin, Eun-Hee Cho, Ha Young Kim; J Bone Metab 2017;24(2):117-124.
Published online May 31, 2017; DOI: https://doi.org/10.11005/jbm.2017.24.2.117

Background

The aim of this study was to evaluate the longitudinal changes of trabecular bone score (TBS) during and after bisphosphonate (BP) treatment in postmenopausal Korean women with osteoporosis.

Methods

We analyzed 191 patients who took BP and underwent bone mineral density (BMD) test for the period from January 2010 to December 2015. The mean follow up period during treatment and after treatment was 22.8 months and 18 months, respectively. The TBS and BMD values were evaluated by the percent changes relative to the baseline.

Results

In 191 patients, who treated with BPs, L-spine BMD increased 3.65±0.5% and TBS increased 0.26±0.4% from baseline during first 1 year. At 2 to 4 years, the changes of BMD and TBS from baseline gradually increased up to 9.3±3.25% and 2.69±0.98% and both results showed statistically significant correlation. In 86 patients who stopped BPs, L-spine BMD decreased -0.54±1.07% and TBS increased 0.33±1.96% from baseline during 3 years follow up period.

Conclusions

Lumbar spine TBS increase over time with BPs treatment although the changes were less than that of BMD. Also, it preserve for years after stopping treatment, as the changes of lumbar spine BMD. The results of BMD and TBS showed significant correlation during treatment but not during drug withdrawal.

Citations

Citations to this article as recorded by

1. Trabecular Bone Score: From Over a Decade of Evidence to a Connected Bone Health Ecosystem
Karen Hind, Madeleine Davies, Elena Gonzalez-Rodriguez, Didier Hans
Osteologie.2025; 34(03): 213. CrossRef
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Heenam Goel, Neil Binkley, Miranda Boggild, Wing P. Chan, William D. Leslie, Eugene McCloskey, Sarah L. Morgan, Barbara C. Silva, Angela M. Cheung
Journal of Clinical Densitometry.2024; 27(1): 101452. CrossRef
3. Il ruolo del Trabecular Bone Score (TBS) nella gestione dell’osteoporosi primaria e secondaria
Fabio Bioletto, Massimo Procopio, Marco Barale
L'Endocrinologo.2024; 25(6): 634. CrossRef
4. Trabecular Bone Score to Enhance Fracture Risk Prediction and Treatment Strategies in Osteoporosis
Guillaume Gatineau, Didier Hans, Karen Hind
Seminars in Musculoskeletal Radiology.2024; 28(05): 539. CrossRef
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Joao Pedro Pinho, Arturo Forner-Cordero, Rosa Maria Rodrigues Pereira, Arnaldo Jose Hernandez, Egidio Lima Dorea, Bruno Mezencio, Liliam Takayama, Jackeline Couto Alvarenga, Julio Cerca Serrao, Alberto Carlos Amadio
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