The OsteoLaus Cohort Study Bone mineral density, micro-architecture score and vertebral fracture assessment extracted from a single DXA device in combination with clinical risk factors improve significantly the identification of women at high risk of fracture

Indirect micro-architectural (MA) approximation is evaluable in daily practice by the Trabecular Bone Score (TBS) measure. The aim of the OsteoLaus cohort is to combine CRF and the information given by DXA (bone mineral density [BMD], TBS and vertebral fracture assessment [VFA]) to better identify women at high fracture risk. We included 631 women: mean age 67.4 +/- 6.7 y, BMI 26.1 +/- 4.6. Correlation between BMD and site matched TBS was low (r(2)=0.16). Prevalence of vertebral fractures (VFx) grade 2/3, major OP Fx and all OP Fx was 8.4%, 17.0% and 26.0% respectively. Age- and BMI-adjusted ORs (per SD decrease) were 1.8 (1.2-2.5), 1.6 (1.2-2.1), 1.3 (1.1-1.6) for BMD and 2.0 (1.4-3.0), 1.9 (1.4-2.5), 1.4 (1.1-1.7) for TBS respectively. The TBS ORs (per SD decrease) adjusted for age, BMI and spine BMD for VFx grade 2/3, major and all OP Fx were 1.7 (1.1-2.7), 1.6 (1.2-2.2) and 1.3 (1.0-1.7) respectively. Only 35 to 44% of women with OP Fx had a BMD < -2.5 SD or a TBS < 1.200. If we combine a BMD < -2.5 SD or a TBS < 1.200, 54 to 60% of women with an OP Fx are identified. Therefore by using VFA, BMD, and TBS from a simple and low ionizing radiation device, the DXA, we can obtain additional informations which are useful for the patient in the daily practice.