SAT-537 Trabecular Bone Score in Healthy Adult Population of India: Chandigarh Urban Bone Epidemiological Study (CUBES)

Purpose: Trabecular bone score (TBS), a textural analysis of the lumbar spine image, utilized complementary to dual energy x-ray absorptiometry (DXA) has been shown to assess bone quality and capture fracture risk. As bone mineral density (BMD) varies with ethnicity, TBS is also expected to vary. Indians have lower BMD than their Western counterparts. The aim of this study was to generate normative data on TBS in healthy Indian population. Methods: Study population included 1225 healthy volunteers, ages 20-80 years, recruited from Chandigarh, India. Following comprehensive biochemical evaluation, BMD was assessed in all participants by DXA. TBS (L1-L4) was calculated utilizing TBS iNsight software in 600 participants. Results: Mean age of the study population (n=600) was 44.0 ± 14.3 years with 41.2% males and 58.8% females. Highest TBS was noted in both male and female subjects in the youngest decade (20-29 years), 1.301 ± 0.12 and 1.274 ± 0.14 respectively. TBS was higher in males compared to females at each decade. TBS decreased with age by 2-3 % per decade. Mean TBS in males aged >50 years was 1.162 ± 0.112 and in postmenopausal females was 1.424 ± 0.111. Modest negative correlation was found between TBS and age (r = -0.377) and very weak negative correlation between TBS and vitamin D (r = -0.125). Significant positive correlation was found between BMD and TBS. Per TBS cut-offs proposed for western population, normal, partially degraded, and degraded micro-architecture was noted in 21%, 14.5% and 64.5% of postmenopausal females. Conclusion: Age and gender specific reference curves generated from this cohort can be used for osteoporosis management in India. Applying the western thresholds may lead to overestimation of fracture risk.