I will be asking that a Trabecular Bone Score (TBS) be included with my next DXA scan. The doctor who read my latest scan wrote, "Follow up with DEXA and TBS: As needed."
I found a review of TBS. The review includes a section on "Changes in TBS with Treatment of Osteoporosis." Below is the paragraph comparing the effects of strontium ranelate and alendronate (Fosamax) on TBS.
"The effects of strontium ranelate (SrRan) and alendronate on TBS were evaluated in a post hoc analysis performed in 79 women with postmenopausal osteoporosis of 189 included in a double‐blind, double‐dummy, randomized study. Women were randomized to either SrRan 2 g/day or alendronate 70 mg/week for 2 years. TBS and BMD parameters were assessed in the LS after 12 and 24 months of treatment. Over 1 and 2 years, LS BMD increased significantly by 5.6% and 9.0% in the SrRan group and by 5.2% and 7.6%, respectively, in the alendronate group. LS TBS increased by 2.3% (p < 0.001) and 3.1% (p < 0.001) in the SrRan group, but the change in the alendronate group was not significant (0.5% and 1.0%, respectively). There was a significant between‐group difference with SrRan showing larger TBS increases than alendronate."
Let me reiterate: Over one and two years, Lumbar Spine (LS) BMD increased in both the SrRan (5.6%, 9.0%) and alendronate groups (5.2%, 7.6%). You will note that the SrRan BMD numbers are higher, especially after the second year, than the alendronate numbers. The results are as expected because strontium results in an overestimation of BMD.
HERE IS THE KICKER: LS TBS increased by 2.3% and 3.1% in the SrRan group, but the change in the alendronate group was not significant (0.5% and 1.0%, respectively). There was a significant between‐group difference with SrRan showing larger TBS increases than alendronate.
Keep in mind that TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard BMD measurement. TBS may be a better predictor of fracture risk than BMD alone.
https://www.panoramaortho.com/wp-content/uploads/2019/03/TBS-Rev...
Skeleton Pirate
Artist: LindaB
Tuesday, August 23, 2022
Trabecular Bone Score (TBS)
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Wandering Skeleton
Artist: Joel Hoekstra
Osteoporotic Bone
Source: www.mayoclinic.com
2 comments:
If DXA is inflated by strontium and dxa readings are used for the TBS. Is the TBS affected falsely by strontium. What I am reading implies no, but I can find no definite NO in the research.
To: Anonymous of January 17, 2023
I recently had the opportunity to ask Prof. Didier Hans, the co-inventer of TBS software, a question by email:
Will a TBS score be affected by the bone strontium effect, as the BMD by DXA scan is?
Below is his answer:
In our study of TBS and strontium ranelate, TBS was less affected by the larger atomic number of strontium than the BMD was affected. So, the study showed that strontium improved bone microarchitecture.
https://strontiumforbones.blogspot.com/2022/09/tbs-strontium-and-prof-didier-hans.html
https://strontiumforbones.blogspot.com/2022/09/beneficial-effects-of-strontium.html
The trabecular bone score (TBS) does not use DXA scan readings of BMD. TBS uses standard DXA spine images to measure texture inhomogeneity — that is, how well-structured or poorly structured the trabecular bone appears when assessed as individual voxels. To do so, TBS utilizes a software program installed on a standard DXA computer to provide an index of bone microarchitecture based upon the assessed trabecular texture.
https://www.mayoclinic.org/medical-professionals/endocrinology/news/new-tools-to-predict-fracture-risk/mac-20430573
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