Assessment of bone quality with trabecular bone score in type 2 diabetes mellitus: A study from the FRISBEE cohort

Objective The purpose of our study was to compare bone mineral density (BMD) and trabecular bone score (TBS) values between patients with type 2 diabetes (T2D) and control subjects with similar FRAX scores in order to evaluate TBS as an additional tool for assessing fracture risk in diabetic subjects. Methods A cross-sectional analysis was performed using BMD results from 260 subjects participating in the FRISBEE study (Fracture RISk Brussels Epidemiological Enquiry), an ongoing prospective epidemiological study in a population-based cohort (Brussels, Belgium) of 3560 postmenopausal women aged 60-85 years. TBS measurement was possible in 1108 subjects from the FRISBEE cohort. Among these 1108 subjects, 65 had known T2D at inclusion. For each diabetic case we selected 3 controls from our database. (n = 195). Diabetic subjects and controls were matched for age and baseline FRAX score for major osteoporotic fractures. Results BMD (g/cm(2)) tended to be higher in T2D than in control subjects, significantly so at the total hip 0.90 +/- 0.13 versus 0.87 +/- 0.12 (P = 0.015). On the contrary, TBS was significantly lower in the T2D group (mean = 1.19 +/- 0.17) compared with the control group (mean = 1.27 +/- 0.13) (P = 0.005). Mean TBS remained significantly lower in T2D (1.22 +/- 0.17) compared with the control group (1.27 +/- 0.13) (P = 0.02) after adjustment for body mass index. Conclusion Our data suggest that TBS complements BMD at the total hip, in demonstrating the "diabetes-associated bone disease".