Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited Utility
Purpose: Ankylosing spondylitis (AS) not only results in pathological ossification of the spine, but can also be associated with osteoporosis. Due to the presence of syndesmophytes and possible involvement of the hip joints, classical dual X-ray absorptiometry (DXA) is of limited use in patients wit...
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MDPI AG
2021-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/22/5373 |
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| author | Anna Nowakowska-Płaza Jakub Wroński Iwona Sudoł-Szopińska Piotr Głuszko |
| author_facet | Anna Nowakowska-Płaza Jakub Wroński Iwona Sudoł-Szopińska Piotr Głuszko |
| author_sort | Anna Nowakowska-Płaza |
| collection | DOAJ |
| description | Purpose: Ankylosing spondylitis (AS) not only results in pathological ossification of the spine, but can also be associated with osteoporosis. Due to the presence of syndesmophytes and possible involvement of the hip joints, classical dual X-ray absorptiometry (DXA) is of limited use in patients with advanced stages of AS. Trabecular bone score (TBS) is a method complementary to DXA, providing additional information about bone microarchitecture. There is a growing body of evidence for the usefulness of TBS in AS patients. The aim of this study was to assess the clinical utility of TBS in patients with AS. Methods: Patients with AS underwent DXA with additional TBS assessment. A cross-sectional analysis of the frequency of osteoporosis and bone microarchitecture deterioration and their association with patients’ characteristics was done. Results: A total of 51 male patients, mean age 40.7 years, were enrolled. Osteoporosis was diagnosed in seven patients (13.7%). Lumbar bone mineral density (BMD) was higher (<i>p</i> < 0.001) than femoral BMD, indicating abnormal BMD readings in the spine caused by syndesmophytes. Patients with DXA-diagnosed osteoporosis had lower TBS (<i>p</i> = 0.03) and TBS T-score (<i>p</i> = 0.043) values compared to patients without osteoporosis. However, disturbed bone microarchitecture (TBS < 1.23) was present in only three patients (5.9%). None of the patients had a history of an osteoporotic fracture. A lower TBS T-score (<i>p</i> = 0.032) was demonstrated in patients with sacroiliitis grade 4 than in patients with sacroiliitis grade 2, with no significant differences in BMD and T-score values. Conclusion: Among patients with early AS, the clinical utility of TBS is limited—it does not add value to DXA. |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T05:24:00Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-bdb5bb94366b4740bf763bab095266ec2023-11-22T23:50:25ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011022537310.3390/jcm10225373Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited UtilityAnna Nowakowska-Płaza0Jakub Wroński1Iwona Sudoł-Szopińska2Piotr Głuszko3Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, PolandDepartment of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, PolandDepartment of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, PolandDepartment of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, PolandPurpose: Ankylosing spondylitis (AS) not only results in pathological ossification of the spine, but can also be associated with osteoporosis. Due to the presence of syndesmophytes and possible involvement of the hip joints, classical dual X-ray absorptiometry (DXA) is of limited use in patients with advanced stages of AS. Trabecular bone score (TBS) is a method complementary to DXA, providing additional information about bone microarchitecture. There is a growing body of evidence for the usefulness of TBS in AS patients. The aim of this study was to assess the clinical utility of TBS in patients with AS. Methods: Patients with AS underwent DXA with additional TBS assessment. A cross-sectional analysis of the frequency of osteoporosis and bone microarchitecture deterioration and their association with patients’ characteristics was done. Results: A total of 51 male patients, mean age 40.7 years, were enrolled. Osteoporosis was diagnosed in seven patients (13.7%). Lumbar bone mineral density (BMD) was higher (<i>p</i> < 0.001) than femoral BMD, indicating abnormal BMD readings in the spine caused by syndesmophytes. Patients with DXA-diagnosed osteoporosis had lower TBS (<i>p</i> = 0.03) and TBS T-score (<i>p</i> = 0.043) values compared to patients without osteoporosis. However, disturbed bone microarchitecture (TBS < 1.23) was present in only three patients (5.9%). None of the patients had a history of an osteoporotic fracture. A lower TBS T-score (<i>p</i> = 0.032) was demonstrated in patients with sacroiliitis grade 4 than in patients with sacroiliitis grade 2, with no significant differences in BMD and T-score values. Conclusion: Among patients with early AS, the clinical utility of TBS is limited—it does not add value to DXA.https://www.mdpi.com/2077-0383/10/22/5373osteoporosisankylosing spondylitisDXAtrabecular bone score |
| spellingShingle | Anna Nowakowska-Płaza Jakub Wroński Iwona Sudoł-Szopińska Piotr Głuszko Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited Utility Journal of Clinical Medicine osteoporosis ankylosing spondylitis DXA trabecular bone score |
| title | Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited Utility |
| title_full | Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited Utility |
| title_fullStr | Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited Utility |
| title_full_unstemmed | Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited Utility |
| title_short | Trabecular Bone Score (TBS) in Patients with Early Ankylosing Spondylitis—Limited Utility |
| title_sort | trabecular bone score tbs in patients with early ankylosing spondylitis limited utility |
| topic | osteoporosis ankylosing spondylitis DXA trabecular bone score |
| url | https://www.mdpi.com/2077-0383/10/22/5373 |
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