Comparison of FRAX and FRAX-TBS in predicting osteoprotic fracture risk in postmenopausal women

Trabecular Bone Score (TBS) is an index of bone microarchitecture that provides additional skeletal information to areal Bone Mineral Density (aBMD). Recently TBS data has been used to optimize the Fracture Risk Assessment Tool (FRAX) predictive value. Aim of this study was to evaluate the clinical value of TBS on FRAX algorithm.

545 postmenopausal women (mean age 61.64±7.94 years) indicated for bone densitometry were tested for aBMD and TBS. 96 women was diagnosed as osteoporotic and 140 osteopenic women were identified. FRAX and TBS adjusted FRAX (FRAX-TBS) were calculated and compared.

Mean score of TBS was 1.29± 0.09. A strong positive correlation was observed between FRAX and FRAX-TBS in predicting the risk of major osteoporotic fracture (r=0.836, p< 0.0001), and hip fracture (r=0.922, p< 0.0001). aBMD adjusted FRAX and FRAX-TBS was assessed in all sample and the osteopenic group. There was significant difference in number of cases need to treatment based on FRAX and FRAX-TBS.

This study showed significant clinical benefit for TBS and adding TBS data to FRAX for decision making in the treatment.