Abstract: SA-PO882

The Trabecular Bone Score as a Tool to Assess Bone Microarchitecture in CKD

Session Information

  • Mineral Disease: CKD-Bone
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

  • 1203 Mineral Disease: CKD-Bone

Authors

  • Ramalho, Janaina de Almeida Mota, None, Sao Paulo, SÃO PAULO, Brazil
  • Marques, Igor, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
  • Jorgetti, Vanda, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Moyses, Rosa M.A., Universidade Nove de Julho, São Paulo, Brazil
  • Hans, Didier, Lausanne University Hospital - CHUV, Lausanne, Switzerland
  • Nickolas, Thomas, Columbia University Medical Center, New York, New York, United States
Background

Recent studies have demonstrated that low bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) predicts fractures in CKD patients. However, as bone strength reflects the integration of both BMD and bone quality, BMD only partially describes fracture risk. The Trabecular Bone Score (TBS) is a novel clinical tool that uses grayscale variograms of the lumbar spine image from DXA to assess bone quality and fracture risk. Its ability to assess trabecular (Tb) bone quality has been validated against bone biopsy in the general population but not in CKD. We hypothesized that TBS would reflect Tb bone quality at the iliac crest in CKD patients.

Methods

In 52 CKD patients from Columbia University, USA and University of Sao Paulo, Brazil, we determined Spearman correlations controlling for age between TBS and bone microarchitecture assessed by both high-resolution peripheral quantitative computed tomography (HR-pQCT) at the radius and tibia and iliac crest bone histomorphometry.

Results

Mean age was 50.4 ± 15.5 years, 35 (67%) were on dialysis; 25%, 18% and 13% had T-Scores ≤ -2.5 at spine, femoral neck and total hip respectively. Mean TBS was 1.29±0.13 (normal TBS ≥1.35). Correlations between TBS and microarchitectural parameters are shown in Table.

Conclusion

TBS reflects Tb microarchitecture from bone biopsy and Ct and Tb microarchitecture from HR-pQCT. TBS may be a useful tool in the clinic to assess bone quality and fracture risk in CKD patients.

Partial Spearman Correlations
Histomorphometry
BV/TV0.55 (p < 0.001)
TbWidth0.53 (p < 0.001)
TbN0.18 (p = 0.24)
TbSp-0.21 (p = 0.17)
CtWidth-0.16 (p = 0.30)
CtPo-0.21 (p = 0.18)
Radius HR-pQCT
Total density0.37 (p = 0.01)
Ct density0.18 (p = 0.24)
Tb density0.43 (p = 0.003)
CtTh0.31 (p = 0.04)
TbN0.13 (p = 0.40)
TbTh0.43 (p < 0.004)
TbSp-0.17 (p = 0.28)
Tibia HR-pQCT
Total density0.18 (p = 0.23)
Ct density0.19 (p = 0.21)
Tb density0.29 (p = 0.05)
CtTh0.26 (p = 0.08)
TbN0.28 (p = 0.06)
TbTh0.14 (p = 0.36)
TbSp-0.29 (p = 0.05)

BV/TV trabecular bone volume, Th thickness, N number, Sp separation, Po porosity

Funding

  • Other NIH Support