Journal article
Trabecular bone score in kidney transplant recipients.
- Naylor KL Institute for Clinical Evaluative Sciences (ICES), London, ON, Canada.
- Lix LM Department of Medicine, University of Manitoba, Winnipeg, ON, Canada.
- Hans D Centre for Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
- Garg AX Institute for Clinical Evaluative Sciences (ICES), London, ON, Canada.
- Rush DN Department of Medicine, University of Manitoba, Winnipeg, ON, Canada.
- Hodsman AB Division of Nephrology, Western University, London, ON, Canada.
- Leslie WD Department of Medicine, University of Manitoba, Winnipeg, ON, Canada. BLESLIE@sbgh.mb.ca.
- 2015-11-27
Published in:
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - 2016
Bone mineral density
Fracture
Kidney transplant recipient
Trabecular bone score
Absorptiometry, Photon
Adult
Bone Density
Cancellous Bone
Case-Control Studies
Databases, Factual
Female
Femur Neck
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Kidney Transplantation
Lumbar Vertebrae
Male
Middle Aged
Osteoporotic Fractures
Risk Assessment
English
SUMMARY
It is uncertain whether bone mineral density (BMD) can accurately predict fracture in kidney transplant recipients. Trabecular bone score (TBS) provides information independent of BMD. Kidney transplant recipients had abnormal bone texture as measured by lumbar spine TBS, and a lower TBS was associated with incident fractures in recipients.
INTRODUCTION
Trabecular bone score (TBS) is a texture measure derived from dual energy X-ray absorptiometry (DXA) lumbar spine images, providing information independent of bone mineral density. We assessed characteristics associated with TBS and fracture outcomes in kidney transplant recipients.
METHODS
We included 327 kidney transplant recipients from Manitoba, Canada, who received a post-transplant DXA (median 106 days post-transplant). We matched each kidney transplant recipient (mean age 45 years, 39% men) to three controls from the general population (matched on age, sex, and DXA date). Lumbar spine (L1-L4) DXA images were used to derive TBS. Non-traumatic incident fracture (excluding hand, foot, and craniofacial) (n = 31) was assessed during a mean follow-up of 6.6 years. We used multivariable linear regression models to test predictors of TBS, and multivariable Cox proportional hazard regression was used to estimate hazard ratios (HRs) per standard deviation decrease in TBS to express the gradient of risk.
RESULTS
Compared to the general population, kidney transplant recipients had a significantly lower lumbar spine TBS (1.365 ± 0.129 versus 1.406 ± 0.125, P < 0.001). Multivariable linear regression revealed that receipt of a kidney transplant was associated with a significantly lower mean TBS compared to controls (-0.0369, 95% confidence interval [95% CI] -0.0537 to -0.0202). TBS was associated with fractures independent of the Fracture Risk Assessment score including BMD (adjusted HR per standard deviation decrease in TBS 1.64, 95% CI 1.15-2.36).
CONCLUSION
Kidney transplant recipients had abnormal bone texture as assessed by TBS and a lower lumbar spine TBS was associated with fractures in recipients.
It is uncertain whether bone mineral density (BMD) can accurately predict fracture in kidney transplant recipients. Trabecular bone score (TBS) provides information independent of BMD. Kidney transplant recipients had abnormal bone texture as measured by lumbar spine TBS, and a lower TBS was associated with incident fractures in recipients.
INTRODUCTION
Trabecular bone score (TBS) is a texture measure derived from dual energy X-ray absorptiometry (DXA) lumbar spine images, providing information independent of bone mineral density. We assessed characteristics associated with TBS and fracture outcomes in kidney transplant recipients.
METHODS
We included 327 kidney transplant recipients from Manitoba, Canada, who received a post-transplant DXA (median 106 days post-transplant). We matched each kidney transplant recipient (mean age 45 years, 39% men) to three controls from the general population (matched on age, sex, and DXA date). Lumbar spine (L1-L4) DXA images were used to derive TBS. Non-traumatic incident fracture (excluding hand, foot, and craniofacial) (n = 31) was assessed during a mean follow-up of 6.6 years. We used multivariable linear regression models to test predictors of TBS, and multivariable Cox proportional hazard regression was used to estimate hazard ratios (HRs) per standard deviation decrease in TBS to express the gradient of risk.
RESULTS
Compared to the general population, kidney transplant recipients had a significantly lower lumbar spine TBS (1.365 ± 0.129 versus 1.406 ± 0.125, P < 0.001). Multivariable linear regression revealed that receipt of a kidney transplant was associated with a significantly lower mean TBS compared to controls (-0.0369, 95% confidence interval [95% CI] -0.0537 to -0.0202). TBS was associated with fractures independent of the Fracture Risk Assessment score including BMD (adjusted HR per standard deviation decrease in TBS 1.64, 95% CI 1.15-2.36).
CONCLUSION
Kidney transplant recipients had abnormal bone texture as assessed by TBS and a lower lumbar spine TBS was associated with fractures in recipients.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00198-015-3424-3
- PMID 26608055
- Persistent URL
- https://sonar.ch/global/documents/259276
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