Usefulness of the trabecular bone score for assessing the risk of osteoporotic fracture

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"apellidos" => "Kanterewicz" "email" => array:1 [ 0 => "ekanterewicz@chv.cat" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Servicio de Urgencias Consorci Hospitalari de Vic, Vic, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Epidemiología Clínica, Consorci Hospitalari de Vic, Vic, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Reumatología, Consorci Hospitalari de Vic, Vic, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de Metabolismo Óseo, Servicio de Reumatología, Hospital Clinic, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Grupo de investigación TR2LAB, Universitat de Vic, Universitat Central de Catalunya, Vic, Barcelona, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad del Trabecular Bone Score en la valoración del riesgo de fractura osteoporótica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2200 "Ancho" => 2500 "Tamanyo" => 193719 ] ] "descripcion" => array:1 [ "en" => "FRODOS cohort diagram." ] ] ] "textoCompleto" => "BackgroundOsteoporosis is a skeletal disorder characterized by reduced bone mass and quality, which entails lower bone resistance and increased risk of fracture.<a class="elsevierStyleCrossRef" href="#bib0165">1</a> In postmenopausal women, the diagnosis of osteoporosis is established based on the results of bone densitometry using the dual energy X-ray absorptiometry (DXA) technique, which classifies bone constitution in the range of normality, osteopenia or osteoporosis.<a class="elsevierStyleCrossRef" href="#bib0170">2</a> This classification, created by the World Health Organization in 1994, is also used as the therapeutic threshold and for the assessment of fracture risk and is based on the linear relationship between lower bone mineral density (BMD) and the development of fractures.<a class="elsevierStyleCrossRef" href="#bib0175">3</a> However, approximately 50% of fractures due to frailty observed in follow-up cohort studies occur in individuals whose BMD is in the osteopenia range and even in the normal range.<a class="elsevierStyleCrossRef" href="#bib0180">4</a>The results provided by bone densitometry therefore do not establish with acceptable accuracy that individuals are more prone to experiencing fractures. In recent years, risk scales have been created that add other factors involved in the pathogenesis of fractures (age, body mass index, previous fractures, use of glucocorticoids, etc.) to densitometry; however, their predictive capacity usually does not exceed 70%.<a class="elsevierStyleCrossRefs" href="#bib0185">5,6</a> It can therefore be inferred that when a fracture is caused by frailty there is deficient bone quality and resistance. It has been suggested that trabecular bone microarchitecture abnormalities, not detected by densitometry, could be at least partially responsible for this lower resistance and poorer quality of bone tissue.<a class="elsevierStyleCrossRef" href="#bib0195">7</a>In the search for elements that could improve the information provided by DXA densitometry, a trabecular bone structure score system has been recently described: the trabecular bone score (TBS). TBS is a texture parameter that reflects the greyscale variations in the pixels from DXA images.<a class="elsevierStyleCrossRef" href="#bib0200">8</a> These variations indirectly show the condition of the bone microarchitecture. A lower TBS is associated with a low number of trabeculae and a weaker connection between them, while high values are correlated with a stronger trabecular structure.<a class="elsevierStyleCrossRef" href="#bib0205">9</a> TBS, as with BMD, decreases with age and has been slightly but significantly associated, both in retrospective and prospective studies, with the development of fractures.<a class="elsevierStyleCrossRefs" href="#bib0210">10–14</a> Furthermore, in disorders that only slightly change BMD but are associated with a greater risk of fracture, such as type 2 diabetes mellitus (DM2)<a class="elsevierStyleCrossRef" href="#bib0235">15</a> and glucocorticoid treatment,<a class="elsevierStyleCrossRef" href="#bib0240">16</a> it has been suggested that TBS improves the identification of patients with a risk of fracture.Although a number of Spanish clinical studies have been published on the usefulness of TBS,<a class="elsevierStyleCrossRefs" href="#bib0230">14,17–19</a> there have been no population studies on TBS in postmenopausal women in Spain. The aim of this study was to analyze the TBS of a cohort population of postmenopausal women (Osteoporotic Fractures of Osona [FRODOS] cohort),<a class="elsevierStyleCrossRefs" href="#bib0260">20–22</a> created to study the risk of osteoporotic fracture, and relate the values to the clinical characteristics, BMD values and history of fractures in this population group.Materials and methodsThe FRODOS cohort was designed to study the risk factors for frailty fractures in postmenopausal women of the Osona region (Barcelona, Spain). The cohort consisted of a baseline cohort recruited between 2006 and 2009 (2968 women between the ages of 59 and 70 years) and a follow-up group between 2011 and 2013 (2510 women) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), in which the participants signed an informed consent document. The selection criteria and the cohort's characteristics have been described in previous publications.<a class="elsevierStyleCrossRefs" href="#bib0260">20–22</a> In the present study, we analyzed several clinical and densitometric parameters from the 2510 participants who completed the follow-up period. The study was approved by the clinical research ethics committee of the Osona Foundation for Healthcare Research and Education (FORES) (reference 2014/858-PR88).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The main study parameters included the following: a clinical-epidemiological survey on the risk factors for osteoporosis and a history of postmenopausal fractures, anthropometric data (weight, height and body mass index [BMI, kg/m2]), bone densitometry in the lumbar spine and femur and the prevalence of vertebral fractures using morphometry.<a class="elsevierStyleCrossRef" href="#bib0270">22</a> We specifically added the variable “frailty fractures”, which included women who reported a history of postmenopausal fractures in the initial survey and those with vertebral fractures found during the baseline study using vertebral DXA morphometry.DensitometryThe DXA densitometries of the lumbar spine (L1–L4) and proximal femur (total femur and femoral neck) were obtained with a GE Lunar Prodigy Advance densitometer, which has the standardized databases for the Spanish population. According to the World Health Organization criteria,<a class="elsevierStyleCrossRef" href="#bib0170">2</a> we established the following diagnostic categories: normal value (T score>−1), osteopenia (T score between −1 and −2.5) and osteoporosis (T score<−2.5). For the osteoporosis and osteopenia diagnosis, we considered the lowest value detected in any of the 2 locations (lumbar spine and femur).Evaluation of the trabecular bone scoreWe applied TBS iNsight Clinical Data Analyzer software (version 2.1.0.2, Medimaps) on the baseline DXA images and calculated the mean TBS in L1–L4. The TBS (expressed in arbitrary units) were grouped into 3 categories: TBS≥1.310, normal microarchitecture; TBS between 1.230 and 1.310, partially deteriorated microarchitecture; and TBS≤1.230, degraded microarchitecture.<a class="elsevierStyleCrossRef" href="#bib0275">23</a> We excluded 253 women (10.1%) with a BMI>35kg/m2 from the analysis due to the lack of TBS validation for this population subgroup.<a class="elsevierStyleCrossRef" href="#bib0235">15</a>Statistical analysisWe performed a descriptive analysis of the sample, calculating the frequencies and percentages of each categorical variable. For the quantitative variables, we calculated the mean and standard deviation. We performed a bivariate analysis to identify the variables associated with the TBS. To analyze the relationship between the TBS and the categorical variables, we used Student's t-test or ANOVA and simple linear regressions. To analyze the relationship between the TBS and the quantitative variables, we calculated Pearson's correlation coefficient and simple linear regressions. We then performed a multiple linear regression with the significant variables in the univariate models. All statistical tests were performed with a 95% significance level. For the statistical analysis, we employed the Statistical Package for the Social Sciences software (version 21.0 for Windows, released 2012; IBM Corp., Armonk, NY).Results<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> lists the characteristics of the 2257 women included in the study. Some 18.8% of the women had normal BMD values, 51.3% had osteopenia, and 29.9% had osteoporosis. It is worth noting that 8.8% had DM2, and 5.4% were undergoing glucocorticoid treatment.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Some 19.1% of the women (n=430) had a history of postmenopausal fractures, and 4% (n=90) had prevalent vertebral fractures in the morphometric study (analyzed using DXA). Additionally, 1.7% (n=38) of the participants presented both types of fractures; ultimately, 482 women had frailty fractures.The mean TBS was 1.203±0.121. Some 18.2% of the participants had normal values, 26.5% had values indicating partially deteriorated microarchitecture, and 55.3% had values indicating degraded microarchitecture.In the women with osteoporosis, the TBS was 1.157±0.12; in those with osteopenia, the TBS was 1.213±0.12; and in the women with normal densitometry, the TBS was 1.245±0.12 (p<.001). Additionally, 71% of the women with densitometric osteoporosis had degraded microarchitecture, a finding that was observed in 51% of the women with osteopenia and 42.1% of those with normal BMD (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>The women with DM2 and those undergoing glucocorticoid treatment had significantly lower TBS than the other participants (p<.001). Similarly, the women with frailty fractures (n=482) showed significantly lower TBS than those without fractures (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Furthermore, most of the women with frailty fractures (64.3%) had a degraded TBS, while only 18.1% of the women with normal TBS presented a history of these fractures. This finding was even more frequent when we analyzed the women with frailty fractures and the concomitant presence of degraded TBS and osteoporosis or osteopenia. Therefore, while only 3.2% of the women with frailty fractures concomitantly had a normal TBS and bone densitometry, 58.3% of those with fractures had a degraded TBS associated with the presence of osteoporosis or osteopenia (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>We observed a direct linear relationship between the TBS and BMD. There was an inverse relationship between TBS and the variables of age, height and weight (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). As the age, height and weight increased, the TBS decreased.In the univariate linear regression analysis (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>), the factors associated with TBS were age, height, weight, BMD, lumbar T score, use of glucocorticoids, DM2, a history of postmenopausal fractures, a prevalence of vertebral fractures and frailty fractures.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In the multiple linear regression analysis, most of the risk factors identified in the univariate analysis remained significant, except for lumbar BMD (expressed in g/cm2), prevalent vertebral fractures and postmenopausal fractures considered in isolation.DiscussionThe present study shows that, in a cohort of Spanish postmenopausal women created to study the risk factors of osteoporotic fracture, the mean TBS lies within microarchitecture degradation scores and is related to several clinical and anthropometric factors such as age, weight, height, BMD, a history of frailty fracture, glucocorticoid treatment and the presence of DM2.TBS is a new technique that measures bone texture parameters that are extracted from DXA studies of the lumbar spine and provides an indirect index of the trabecular bone microarchitecture.<a class="elsevierStyleCrossRefs" href="#bib0205">9,15</a> It has been suggested that TBS could also be a complementary technique for BMD quantification using DXA to better estimate the risk of fracture, especially in individuals with normal or osteopenic densitometry values,<a class="elsevierStyleCrossRefs" href="#bib0180">4,7</a> given that TBS could theoretically provide additional information on bone quality not reflected in the BMD.The clinical studies in Spain on TBS have confirmed its usefulness in certain patient groups.<a class="elsevierStyleCrossRefs" href="#bib0230">14,17–19</a> In this study of 2510 postmenopausal women, which excluded those with a BMI>35kg/m2 (the increase in abdominal fat can distort the TBS results),<a class="elsevierStyleCrossRef" href="#bib0235">15</a> the values of this index are inversely related to age, weight and height and positively related to BMD, as has been reported in most population studies.<a class="elsevierStyleCrossRefs" href="#bib0205">9,24,25</a> These studies have shown similar results in terms of the intensity of the association between TBS and age, while the positive relationship with BMD varies according to the anatomical region studied and the participant's epidemiological characteristics.With regard to the clinical variables, a history of a frailty fracture was significantly associated with a lower TBS, both in the univariate and multivariate analysis. Furthermore, most of the women with a history of fractures had a degraded TBS, and in fact only 18% of these had normal values. Although the relationship between TBS and BMD and/or lumbar T score was weakly positive, most of the patients with densitometric osteoporosis (approximately 71%) had a degraded microarchitecture, a finding that was also observed in 50% of the women with osteopenia. This suggests that TBS could provide complementary information for assessing the risk of fracture in this population group.<a class="elsevierStyleCrossRefs" href="#bib0290">26,27</a>It is noteworthy that the TBS for the women with DM2 were significantly lower than those of the participants without this disease. In recent years, an increase has been reported in the risk of fractures in patients with diabetes.<a class="elsevierStyleCrossRef" href="#bib0300">28</a> However, these patients usually present relatively higher BMD values than expected based on the actual rate of fractures.<a class="elsevierStyleCrossRef" href="#bib0300">28</a> This fact suggests that there are other mechanisms, which are not reflected in the BMD, that are involved in the increase in bone frailty of patients with diabetes.<a class="elsevierStyleCrossRef" href="#bib0305">29</a> Similar to our findings, recent studies have shown a reduction in TBS in this population group and have suggested that it could be a useful technique in identifying patients with a risk of fractures.<a class="elsevierStyleCrossRef" href="#bib0310">30</a>The participants who were taking glucocorticoids also had significantly lower TBS than those who were not taking them. The consumption of glucocorticoids is the most common cause of secondary osteoporosis and entails an increase in the risk of fractures, mainly vertebral.<a class="elsevierStyleCrossRef" href="#bib0315">31</a> The pathogenesis of corticosteroid osteoporosis is complex and has been related to several factors such as the underlying disease, the patients’ clinical characteristics, the dosage and treatment time.<a class="elsevierStyleCrossRefs" href="#bib0315">31,32</a> The pathophysiology is multifactorial and is associated with a pronounced reduction in bone formation, which leads to reduced bone mass, along with a deterioration in other qualitative aspects of bone tissue that increase its frailty.<a class="elsevierStyleCrossRef" href="#bib0315">31</a> In this respect, and similar to what happens for patients with diabetes, patients treated with glucocorticoids have fractures with relatively high BMD values, which impedes their preventive treatment.<a class="elsevierStyleCrossRef" href="#bib0320">32</a> In agreement with our results, other authors have reported a reduction in TBS in patients who take glucocorticoids, indicating that this imaging technique could be beneficial in this population subgroup for identifying patients with an increased risk of fracture.<a class="elsevierStyleCrossRefs" href="#bib0235">15,16</a>This study has strengths and limitations. Its strengths include the sample size, the cohort's populational nature and the confirmation of the main associations of TBS in a Spanish population with osteoporosis. The limitations are those inherent in a cohort study that analyzes in a cross-sectional manner the results of a new technique. The study might have selection or baseline and longitudinal biases that could affect its results.In conclusion, in the FRODOS cohort composed of women between the ages of 59 and 70 years, the TBS was mostly located in the degraded microarchitecture category, in relation to aging and reduced BMD. Low TBS were more common in the participants with a history of fracture, those who had undergone glucocorticoid treatment and those who had DM2. These results, consistent with recent studies, suggest that this index could be a useful tool for assessing the risk of osteoporotic fracture.FundingThis project was partly funded by the Ministry of Science and Innovation – Health Institute Carlos III– PI10/00034 and by the Spanish Society for Bone and Mineral Metabolism Research – Project SEIOMM – TBS 2014.Conflicts of interestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1009451" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec968988" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1009452" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec968989" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Densitometry" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Evaluation of the trabecular bone score" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-09-04" "fechaAceptado" => "2017-12-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec968988" "palabras" => array:3 [ 0 => "Bone mineral density" 1 => "Fractures" 2 => "Osteoporosis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec968989" "palabras" => array:3 [ 0 => "Densidad mineral ósea" 1 => "Fracturas" 2 => "Osteoporosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Introduction and objectivesThe trabecular bone score (TBS) is an imaging technique that assesses the condition of the trabecular microarchitecture. Preliminary results suggest that TBS, along with the bone mineral density assessment, could improve the calculation of the osteoporotic fracture risk. The aim of this study was to analyze TBS values and their relationship with the clinical characteristics, bone mineral density and history of fractures of a cohort of posmenopausal women. Materials and methodsWe analyzed 2257 posmenopausal women from the FRODOS cohort, which was created to determine the risk factors for osteoporotic fracture through a clinical survey and bone densitometry with vertebral morphometry. TBS was applied to the densitometry images. TBS values ≤1230 were considered indicative of degraded microarchitecture. We performed a simple and multiple linear regression to determine the factors associated with this index. ResultsThe mean TBS value in L1–L4 was 1.203±0.121. Some 55.3% of the women showed values indicating degraded microarchitecture. In the multiple linear regression analysis, the factors associated with low TBS values were age, weight, height, spinal T-score, glucocorticoid treatment, presence of type 2 diabetes and a history of fractures due to frailty. ConclusionsTBS showed microarchitecture degradation values in the participants of the FRODOS cohort and was associated with anthropometric factors, low bone mineral density values, the presence of fractures, a history of type 2 diabetes mellitus and the use of glucocorticoids." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "Introducción y objetivosEl Trabecular Bone Score (TBS) es una técnica de imagen que evalúa el estado de la microarquitectura trabecular. Resultados preliminares sugieren que, junto a la valoración de la densidad mineral ósea, podría mejorar la estimación del riesgo de fractura ostoporótica. El objetivo de este estudio fue analizar los valores de TBS y su relación con las características clínicas, densidad mineral ósea y antecedentes de fracturas en una cohorte de mujeres posmenopáusicas. Material y métodosAnalizamos 2.257 mujeres posmenopáusicas procedentes de la cohorte FRODOS, constituida para determinar los factores de riesgo de fractura osteoporótica mediante una encuesta clínica y densitometría ósea con morfometría vertebral. Se aplicó el TBS a las imágenes densitométricas. Valores de TBS ≤1,230 se consideraron indicativos de microarquitectura degradada. Se realizó una regresión lineal simple y múltiple para determinar los factores asociados con este índice. ResultadosEl valor medio de TBS en L1-L4 fue de 1,203±0,121. El 55,3% de las mujeres presentaban valores de microarquitectura degradada. En el análisis de regresión lineal múltiple los factores asociados a los valores bajos de TBS fueron la edad, el peso, la altura, escala T de columna lumbar, tratamiento con glucocorticoides, presencia de diabetes tipo 2 y antecedentes de fractura por fragilidad. ConclusionesEl TBS mostró valores de microarquitectura degradada en las participantes de la cohorte FRODOS y se asoció a factores antropométricos, valor bajo de densidad mineral ósea, presencia de fracturas, antecedentes de diabetes mellitus tipo 2 y uso de glucocorticoides." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Redondo L, Puigoriol E, Rodríguez JR, Peris P, Kanterewicz E. Utilidad del Trabecular Bone Score en la valoración del riesgo de fractura osteoporótica. Rev Clin Esp. 2018;218:121–127." ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2200 "Ancho" => 2500 "Tamanyo" => 193719 ] ] "descripcion" => array:1 [ "en" => "FRODOS cohort diagram." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1428 "Ancho" => 3194 "Tamanyo" => 246683 ] ] "descripcion" => array:1 [ "en" => "Trabecular bone score and bone mineral density. (a) A TBS according to the densitometric categories. (b) Correlation between TBS and lumbar T scale in women with frailty fractures." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "The values are expressed as mean±SD.Abbreviation: BMD, bone mineral density." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n=2257 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">65.4±3.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight, kg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">66.7±9.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height, cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">155.74±6.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fracture in postmenopause \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">430 (19.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prevalence of vertebral fractures \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 (4.0%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Frailty fractures<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">482 (21.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucocorticoid treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">121 (5.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">199 (8.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar BMD, g/cm2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.990±0.16 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar spine T score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.591±1.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">425 (18.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Osteopenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1158 (51.3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Osteoporosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">674 (29.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1709668.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "430 women with fractures in postmenopause, 90 women with prevalence of vertebral fractures of which 38 (1.7%) are cases of coinciding fractures." ] ] ] "descripcion" => array:1 [ "en" => "Baseline characteristics of the study population." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Abbreviations: BMD, bone mineral density; TBS, trabecular bone score." "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">TBS values – clinical variables<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a></th></tr><tr title="table-row"><th class="td" title="table-head " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TBS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Fracture in postmenopause</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.208±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top">.001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.179±0.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Prevalence of vertebral fractures</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.204±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top">.001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.161±0.12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Frailty fractures</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.210±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top"><.001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.176±0.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Glucocorticoid treatment</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.205±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top">.001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.167±0.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Diabetes</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.208±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top"><.001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.150±0.14 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="3" align="left" valign="top">BMD</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.245±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top"><.001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Osteopenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.213±0.12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Osteoporosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.157±0.12 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1709667.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Coefficients of correlation TBS – anthropometric and densitometric variables<a class="elsevierStyleCrossRef" href="#tblfn0015">b</a></th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ρ Pearson correlation coefficient \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.203 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.164 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.193 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar BMD, g/cm2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.262 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar spine T score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.261 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1709666.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "Student's t-test or ANOVA." ] 1 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "b" "nota" => "Pearson correlation coefficient. The tests were considered statistically significant when p<.05." ] ] ] "descripcion" => array:1 [ "en" => "Association of the Trabecular Bone Score with clinical, anthropometric and densitometric variables." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Abbreviations: BMD, bone mineral density; CI, confidence interval; DM2, type 2 diabetes mellitus; TBS, trabecular bone score." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TBS \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">β (95% CI) univariate \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">β (95% CI) multivariate \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.007 (−0.008; −0.005) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.005 (−0.007; −0.004) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.003 (−0.004; −0.002) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.003 (−0.004; −0.003) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.002 (−0.003; −0.002) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.003 (−0.004; −0.003) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar BMD, g/cm2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.196 (0.166; 0.226) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar spine T score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.023 (0.020; 0.027) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.034 (0.030; 0.037) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucocorticoid treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.038 (−0.061; −0.016) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.036 (−0.056; −0.017) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DM2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.058 (−0.076; −0.041) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.063 (−0.079; −0.047) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fracture in postmenopause \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.030 (−0.043; −0.017) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prevalence of vertebral fractures \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.043 (−0.069; −0.017) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Frailty fractures \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.034 (−0.047; −0.022) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.019 (−0.030; −0.008) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1709669.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Simple and multiple linear regression analysis." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0165" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis prevention, diagnosis and therapy" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "NIH, consensus development panel on osteoporosis prevention, diagnosis, therapy" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Med Assoc" "fecha" => "2001" "volumen" => "285" "paginaInicial" => "785" "paginaFinal" => "795" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0170" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "WHO Study Group on Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group [meeting held in Rome from 22 to 25 June 1992]" ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "1994" "editorial" => "OMS. Series de informes técnicos 843. Ginebra" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0175" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictive value of BMD for hip and other fractures" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Johnell" 1 => "J.A. Kanis" 2 => "A. Oden" 3 => "H. Johansson" 4 => "C. De Laet" 5 => "P. Delmas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1359/JBMR.050304" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "2005" "volumen" => "20" "paginaInicial" => "1185" "paginaFinal" => "1194" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15940371" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0180" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in posmenopausal women aged 50–99; results from the National Osteoporosis Risk Assessment (NORA)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.S. Siris" 1 => "S.K. Brenneman" 2 => "E. Barrett-Connor" 3 => "P.D. Miller" 4 => "S. Sajjan" 5 => "M.L. Berger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-005-0027-4" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2006" "volumen" => "17" "paginaInicial" => "565" "paginaFinal" => "574" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16392027" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0185" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance of risk instruments for predicting osteoporotic fracture risk: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Nayak" 1 => "D.L. Edwards" 2 => "A.A. Saleh" 3 => "S.L. Greenspan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-013-2504-5" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2014" "volumen" => "25" "paginaInicial" => "23" "paginaFinal" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24105431" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0190" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk assessment tools to identify women with increased risk of osteoporotic fracture: complexity or simplicity? A systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K.H. Rubin" 1 => "T. Friis-Holmberg" 2 => "A.P. Hermann" 3 => "B. Abrahamsen" 4 => "K. Brixen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jbmr.1956" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "2013" "volumen" => "28" "paginaInicial" => "1701" "paginaFinal" => "1717" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23592255" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0195" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What's in a name? What constitutes the clinical diagnosis of osteoporosis?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.S. Siris" 1 => "S. Boonen" 2 => "P.J. Mitchell" 3 => "J. Bilezikian" 4 => "S. Silverman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-012-1991-0" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2012" "volumen" => "23" "paginaInicial" => "2093" "paginaFinal" => "2097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22543575" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0200" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlations between grey-level variations in 2D projection images (TBS) and 3D microarchitecture: applications in the study of human trabecular bone microarchitecture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Pothuaud" 1 => "P. Carceller" 2 => "D. Hans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2007.11.018" "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "2008" "volumen" => "42" "paginaInicial" => "775" "paginaFinal" => "787" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18234577" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0205" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trabecular Bone Score TBS: available knowledge, clinical relevance, and future prospects" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "the Scientific Committee of the GRIO (Groupe de Recherche et d’information sur les Ostéoporsoses)" "etal" => false "autores" => array:5 [ 0 => "V. Bousson" 1 => "C. Bergot" 2 => "B. Sutter" 3 => "P. Levitz" 4 => "B. Cortet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-011-1824-6" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2012" "volumen" => "23" "paginaInicial" => "1489" "paginaFinal" => "1501" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22083541" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0210" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clínical factors associated with Trabecular Bone Score" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "W.D. Leslie" 1 => "M.A. Krieg" 2 => "D. Hans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2013.01.006" "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2013" "volumen" => "16" "paginaInicial" => "374" "paginaFinal" => "379" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23452869" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0215" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Added value of Trabecular Bone Score to bone mineral density for prediction of osteoporotic fractures in posmenopausal women: the OPUS study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Briot" 1 => "S. Paternotte" 2 => "S. Kolta" 3 => "R. Eastell" 4 => "D.M. Reid" 5 => "D. Felsenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Bone" "fecha" => "2013" "volumen" => "57" "paginaInicial" => "231" "paginaFinal" => "236" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0220" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Hans" 1 => "A.L. Goertzen" 2 => "M.A. Krieg" 3 => "W.D. Leslie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jbmr.499" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "2011" "volumen" => "26" "paginaInicial" => "2762" "paginaFinal" => "2769" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21887701" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0225" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the potential use of Trabecular Bone Score to complement bone mineral density in the diagnosis of osteoporosis: a preliminary spine BMD-matched, case-control study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Pothuaud" 1 => "N. Barthe" 2 => "M.A. Krieg" 3 => "N. Mehsen" 4 => "P. Carceller" 5 => "D. Hans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2008.11.006" "Revista" => array:6 [ "tituloSerie" => "J Clin Densitom" "fecha" => "2009" "volumen" => "12" "paginaInicial" => "170" "paginaFinal" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19181553" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0230" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is bone microarchitecture status of the lumbar spine assessed by TBS related to femoral neck fracture? A Spanish case–control study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.M. Del Rio" 1 => "R. Winzenrieth" 2 => "C. Cormier" 3 => "S.D. Gregorio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-012-2008-8" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "991" "paginaFinal" => "998" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22581295" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0235" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trabecular Bone Score: a noninvasive analytical method based upon the DXA image" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.C. Silva" 1 => "W.D. Leslie" 2 => "H. Resch" 3 => "O. Lamy" 4 => "O. Lesnyak" 5 => "N. Binkley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bone Min Res" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "518" "paginaFinal" => "530" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0240" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trabecular Bone Score reflects trabecular microarchitecture deterioration and fragility fracture in female adult patients receiving glucocorticoid therapy: a pre-post controlled study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.H. Chuang" 1 => "T.L. Chuang" 2 => "M. Koo" 3 => "Y.F. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2017/4210217" "Revista" => array:5 [ "tituloSerie" => "Biomed Res Int" "fecha" => "2017" "volumen" => "2017" "paginaInicial" => "4210217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28127556" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0245" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "TBS and BMD at the end of AI-therapy: a prospective study of the B-ABLE cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Rodríguez" 1 => "M. Pineda" 2 => "S. Servitja" 3 => "Garcia N" 4 => "T. Martos" 5 => "I. Tusquets" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2016.08.008" "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "2016" "volumen" => "92" "paginaInicial" => "1" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27519968" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0250" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone density, microarchitecture, and tissue quality after long-term treatment with tenofovir/emtricitabine or abacavir/lamivudine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Güerri-Fernández" 1 => "D. Molina-Morant" 2 => "J. Villar-García" 3 => "S. Herrera" 4 => "A. González-Mena" 5 => "A. Guelar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAI.0000000000001396" "Revista" => array:6 [ "tituloSerie" => "J Acquir Immune Defic Syndr" "fecha" => "2017" "volumen" => "75" "paginaInicial" => "322" "paginaFinal" => "327" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28418990" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0255" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison between different bone treatments on areal bone mineral density (aBMD) and bone microarchitectural texture as assessed by the Trabecular Bone Score (TBS)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Di Gregorio" 1 => "L. del Rio" 2 => "J. Rodriguez-Tolra" 3 => "E. Bonel" 4 => "M. García" 5 => "R. Winzenrieth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2014.12.062" "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "2015" "volumen" => "75" "paginaInicial" => "138" "paginaFinal" => "143" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25571842" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0260" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relación del telopéptido carboxiterminal del colágeno tipo I sérico con la densidad mineral ósea y el consumo de fármacos en mujeres posmenopáusicas Datos preliminares del estudio FRODOS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Kanterewicz" 1 => "E. Puigoriol" 2 => "P. Peris" 3 => "L. del Rio" 4 => "P. Rosique" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2009" "volumen" => "133" "paginaInicial" => "609" "paginaFinal" => "614" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0265" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Distribution of serum bCTX in a population-based study of posmenopausal women taking into account different anti-osteoporotic therapies (the FRODOS cohort)" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "FRODOS Research Group" "etal" => false "autores" => array:6 [ 0 => "E. Kanterewicz" 1 => "P. Peris" 2 => "E. Puigoriol" 3 => "A. Yañez" 4 => "P. Rosique" 5 => "L. del Rio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00774-012-0410-0" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Metab" "fecha" => "2013" "volumen" => "31" "paginaInicial" => "231" "paginaFinal" => "239" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23223942" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0270" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of vertebral fractures and minor vertebral deformities evaluated by DXA-assisted vertebral fracture assessment (VFA) in a population-based study of postmenopausal women: the FRODOS study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Kanterewicz" 1 => "E. Puigoriol" 2 => "J. García-Barrionuevo" 3 => "L. del Rio" 4 => "M. Casellas" 5 => "P. Peris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-014-2628-2" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2014" "volumen" => "25" "paginaInicial" => "1455" "paginaFinal" => "1464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24599272" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0275" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A meta-analysis of Trabecular Bone Score in fracture risk prediction and its relationship to FRAX" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.V. McCloskey" 1 => "A. Óden" 2 => "N.C. Harvey" 3 => "W.D. Leslie" 4 => "D. Hans" 5 => "H. Johansson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jbmr.2734" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "2016" "volumen" => "31" "paginaInicial" => "940" "paginaFinal" => "948" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26498132" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0280" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trabecular bone score in healthy ageing" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Bazzocchi" 1 => "F. Ponti" 2 => "D. Diano" 3 => "M. Amadori" 4 => "U. Albisinni" 5 => "G. Battista" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr.20140865" "Revista" => array:5 [ "tituloSerie" => "Br J Radiol" "fecha" => "2015" "volumen" => "88" "paginaInicial" => "20140865" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26148778" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0285" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generation and validation of a normative, age-specific reference curve for lumbar spine trabecular bone score (TBS) in French women" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Dufour" 1 => "R. Winzenrieth" 2 => "A. Heraud" 3 => "D. Hans" 4 => "N. Mehsen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-013-2384-8" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "2837" "paginaFinal" => "2846" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23681084" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0290" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adjusting fracture probability by Trabecular Bone Score" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.V. McCloskey" 1 => "A. Odén" 2 => "N.C. Harvey" 3 => "W.D. Leslie" 4 => "D. Hans" 5 => "H. Johansson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00223-015-9980-x" "Revista" => array:6 [ "tituloSerie" => "Calcif Tissue Int" "fecha" => "2015" "volumen" => "96" "paginaInicial" => "500" "paginaFinal" => "509" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25796374" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0295" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trabecular Bone Score (TBS) predicts vertebral fractures in Japanese women over 10 years independently of bone density and prevalent vertebral deformity: the Japanese population-based osteoporosis (JPOS) cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Iki" 1 => "J. Tamaki" 2 => "E. Kadowaki" 3 => "Y. Sato" 4 => "N. Dongmei" 5 => "R. Winzenrieth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jbmr.2048" "Revista" => array:6 [ "tituloSerie" => "J Bone Miner Res" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "399" "paginaFinal" => "407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23873699" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0300" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Type 2 diabetes and the skeleton: new insights into sweet bones" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V.V. Shanbhogue" 1 => "D.M. Mitchell" 2 => "C.J. Rosen" 3 => "M.L. Bouxsein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-8587(15)00283-1" "Revista" => array:6 [ "tituloSerie" => "Lancet Diabetes Endocrinol" "fecha" => "2016" "volumen" => "4" "paginaInicial" => "159" "paginaFinal" => "173" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26365605" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0305" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes – a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Vestergaard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00198-006-0253-4" "Revista" => array:6 [ "tituloSerie" => "Osteoporos Int" "fecha" => "2007" "volumen" => "18" "paginaInicial" => "427" "paginaFinal" => "444" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17068657" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0310" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trabecular Bone Score (TBS) and TBS-adjusted fracture risk assessment tool are potential supplementary tools for the discrimination of morphometric vertebral fractures in posmenopausal women with type 2 diabetes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y.J. Choi" 1 => "S.Y. Ock" 2 => "Y.S. 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Usefulness of the trabecular bone score for assessing the risk of osteoporotic fracture

Utilidad del Trabecular Bone Score en la valoración del riesgo de fractura osteoporótica

L. Redondoa,e, E. Puigoriolb,e, J.R. Rodríguezc,e, P. Perisd, E. Kanterewiczc,e,

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ekanterewicz@chv.cat

Corresponding author.

a Servicio de Urgencias Consorci Hospitalari de Vic, Vic, Barcelona, Spain

b Unidad de Epidemiología Clínica, Consorci Hospitalari de Vic, Vic, Barcelona, Spain

c Servicio de Reumatología, Consorci Hospitalari de Vic, Vic, Barcelona, Spain

d Unidad de Metabolismo Óseo, Servicio de Reumatología, Hospital Clinic, Barcelona, Spain

e Grupo de investigación TR2LAB, Universitat de Vic, Universitat Central de Catalunya, Vic, Barcelona, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Osteoporosis is a skeletal disorder characterized by reduced bone mass and quality&#44; which entails lower bone resistance and increased risk of fracture&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a> In postmenopausal women&#44; the diagnosis of osteoporosis is established based on the results of bone densitometry using the dual energy X-ray absorptiometry &#40;DXA&#41; technique&#44; which classifies bone constitution in the range of normality&#44; osteopenia or osteoporosis&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> This classification&#44; created by the World Health Organization in 1994&#44; is also used as the therapeutic threshold and for the assessment of fracture risk and is based on the linear relationship between lower bone mineral density &#40;BMD&#41; and the development of fractures&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">3</span></a> However&#44; approximately 50&#37; of fractures due to frailty observed in follow-up cohort studies occur in individuals whose BMD is in the osteopenia range and even in the normal range&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The results provided by bone densitometry therefore do not establish with acceptable accuracy that individuals are more prone to experiencing fractures&#46; In recent years&#44; risk scales have been created that add other factors involved in the pathogenesis of fractures &#40;age&#44; body mass index&#44; previous fractures&#44; use of glucocorticoids&#44; etc&#46;&#41; to densitometry&#59; however&#44; their predictive capacity usually does not exceed 70&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">5&#44;6</span></a> It can therefore be inferred that when a fracture is caused by frailty there is deficient bone quality and resistance&#46; It has been suggested that trabecular bone microarchitecture abnormalities&#44; not detected by densitometry&#44; could be at least partially responsible for this lower resistance and poorer quality of bone tissue&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In the search for elements that could improve the information provided by DXA densitometry&#44; a trabecular bone structure score system has been recently described&#58; the trabecular bone score &#40;TBS&#41;&#46; TBS is a texture parameter that reflects the greyscale variations in the pixels from DXA images&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">8</span></a> These variations indirectly show the condition of the bone microarchitecture&#46; A lower TBS is associated with a low number of trabeculae and a weaker connection between them&#44; while high values are correlated with a stronger trabecular structure&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">9</span></a> TBS&#44; as with BMD&#44; decreases with age and has been slightly but significantly associated&#44; both in retrospective and prospective studies&#44; with the development of fractures&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">10&#8211;14</span></a> Furthermore&#44; in disorders that only slightly change BMD but are associated with a greater risk of fracture&#44; such as type 2 diabetes mellitus &#40;DM2&#41;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a> and glucocorticoid treatment&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">16</span></a> it has been suggested that TBS improves the identification of patients with a risk of fracture&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Although a number of Spanish clinical studies have been published on the usefulness of TBS&#44;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">14&#44;17&#8211;19</span></a> there have been no population studies on TBS in postmenopausal women in Spain&#46; The aim of this study was to analyze the TBS of a cohort population of postmenopausal women &#40;Osteoporotic Fractures of Osona &#91;FRODOS&#93; cohort&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#8211;22</span></a> created to study the risk of osteoporotic fracture&#44; and relate the values to the clinical characteristics&#44; BMD values and history of fractures in this population group&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">The FRODOS cohort was designed to study the risk factors for frailty fractures in postmenopausal women of the Osona region &#40;Barcelona&#44; Spain&#41;&#46; The cohort consisted of a baseline cohort recruited between 2006 and 2009 &#40;2968 women between the ages of 59 and 70 years&#41; and a follow-up group between 2011 and 2013 &#40;2510 women&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; in which the participants signed an informed consent document&#46; The selection criteria and the cohort&#39;s characteristics have been described in previous publications&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#8211;22</span></a> In the present study&#44; we analyzed several clinical and densitometric parameters from the 2510 participants who completed the follow-up period&#46; The study was approved by the clinical research ethics committee of the Osona Foundation for Healthcare Research and Education &#40;FORES&#41; &#40;reference 2014&#47;858-PR88&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The main study parameters included the following&#58; a clinical-epidemiological survey on the risk factors for osteoporosis and a history of postmenopausal fractures&#44; anthropometric data &#40;weight&#44; height and body mass index &#91;BMI&#44; kg&#47;m<span class="elsevierStyleSup">2</span>&#93;&#41;&#44; bone densitometry in the lumbar spine and femur and the prevalence of vertebral fractures using morphometry&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> We specifically added the variable &#8220;frailty fractures&#8221;&#44; which included women who reported a history of postmenopausal fractures in the initial survey and those with vertebral fractures found during the baseline study using vertebral DXA morphometry&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Densitometry</span><p id="par0035" class="elsevierStylePara elsevierViewall">The DXA densitometries of the lumbar spine &#40;L1&#8211;L4&#41; and proximal femur &#40;total femur and femoral neck&#41; were obtained with a GE Lunar Prodigy Advance densitometer&#44; which has the standardized databases for the Spanish population&#46; According to the World Health Organization criteria&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> we established the following diagnostic categories&#58; normal value &#40;<span class="elsevierStyleItalic">T</span> score<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#8722;1&#41;&#44; osteopenia &#40;<span class="elsevierStyleItalic">T</span> score between &#8722;1 and &#8722;2&#46;5&#41; and osteoporosis &#40;<span class="elsevierStyleItalic">T</span> score<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#8722;2&#46;5&#41;&#46; For the osteoporosis and osteopenia diagnosis&#44; we considered the lowest value detected in any of the 2 locations &#40;lumbar spine and femur&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Evaluation of the trabecular bone score</span><p id="par0040" class="elsevierStylePara elsevierViewall">We applied TBS iNsight Clinical Data Analyzer software &#40;version 2&#46;1&#46;0&#46;2&#44; Medimaps&#41; on the baseline DXA images and calculated the mean TBS in L1&#8211;L4&#46; The TBS &#40;expressed in arbitrary units&#41; were grouped into 3 categories&#58; TBS<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>1&#46;310&#44; normal microarchitecture&#59; TBS between 1&#46;230 and 1&#46;310&#44; partially deteriorated microarchitecture&#59; and TBS<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>1&#46;230&#44; degraded microarchitecture&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a> We excluded 253 women &#40;10&#46;1&#37;&#41; with a BMI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> from the analysis due to the lack of TBS validation for this population subgroup&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">We performed a descriptive analysis of the sample&#44; calculating the frequencies and percentages of each categorical variable&#46; For the quantitative variables&#44; we calculated the mean and standard deviation&#46; We performed a bivariate analysis to identify the variables associated with the TBS&#46; To analyze the relationship between the TBS and the categorical variables&#44; we used Student&#39;s <span class="elsevierStyleItalic">t</span>-test or ANOVA and simple linear regressions&#46; To analyze the relationship between the TBS and the quantitative variables&#44; we calculated Pearson&#39;s correlation coefficient and simple linear regressions&#46; We then performed a multiple linear regression with the significant variables in the univariate models&#46; All statistical tests were performed with a 95&#37; significance level&#46; For the statistical analysis&#44; we employed the Statistical Package for the Social Sciences software &#40;version 21&#46;0 for Windows&#44; released 2012&#59; IBM Corp&#46;&#44; Armonk&#44; NY&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> lists the characteristics of the 2257 women included in the study&#46; Some 18&#46;8&#37; of the women had normal BMD values&#44; 51&#46;3&#37; had osteopenia&#44; and 29&#46;9&#37; had osteoporosis&#46; It is worth noting that 8&#46;8&#37; had DM2&#44; and 5&#46;4&#37; were undergoing glucocorticoid treatment&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Some 19&#46;1&#37; of the women &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>430&#41; had a history of postmenopausal fractures&#44; and 4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>90&#41; had prevalent vertebral fractures in the morphometric study &#40;analyzed using DXA&#41;&#46; Additionally&#44; 1&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41; of the participants presented both types of fractures&#59; ultimately&#44; 482 women had frailty fractures&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The mean TBS was 1&#46;203<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;121&#46; Some 18&#46;2&#37; of the participants had normal values&#44; 26&#46;5&#37; had values indicating partially deteriorated microarchitecture&#44; and 55&#46;3&#37; had values indicating degraded microarchitecture&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In the women with osteoporosis&#44; the TBS was 1&#46;157<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&#59; in those with osteopenia&#44; the TBS was 1&#46;213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&#59; and in the women with normal densitometry&#44; the TBS was 1&#46;245<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Additionally&#44; 71&#37; of the women with densitometric osteoporosis had degraded microarchitecture&#44; a finding that was observed in 51&#37; of the women with osteopenia and 42&#46;1&#37; of those with normal BMD &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The women with DM2 and those undergoing glucocorticoid treatment had significantly lower TBS than the other participants &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Similarly&#44; the women with frailty fractures &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>482&#41; showed significantly lower TBS than those without fractures &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Furthermore&#44; most of the women with frailty fractures &#40;64&#46;3&#37;&#41; had a degraded TBS&#44; while only 18&#46;1&#37; of the women with normal TBS presented a history of these fractures&#46; This finding was even more frequent when we analyzed the women with frailty fractures and the concomitant presence of degraded TBS and osteoporosis or osteopenia&#46; Therefore&#44; while only 3&#46;2&#37; of the women with frailty fractures concomitantly had a normal TBS and bone densitometry&#44; 58&#46;3&#37; of those with fractures had a degraded TBS associated with the presence of osteoporosis or osteopenia &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">We observed a direct linear relationship between the TBS and BMD&#46; There was an inverse relationship between TBS and the variables of age&#44; height and weight &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; As the age&#44; height and weight increased&#44; the TBS decreased&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In the univariate linear regression analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#44; the factors associated with TBS were age&#44; height&#44; weight&#44; BMD&#44; lumbar <span class="elsevierStyleItalic">T</span> score&#44; use of glucocorticoids&#44; DM2&#44; a history of postmenopausal fractures&#44; a prevalence of vertebral fractures and frailty fractures&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">In the multiple linear regression analysis&#44; most of the risk factors identified in the univariate analysis remained significant&#44; except for lumbar BMD &#40;expressed in g&#47;cm<span class="elsevierStyleSup">2</span>&#41;&#44; prevalent vertebral fractures and postmenopausal fractures considered in isolation&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">The present study shows that&#44; in a cohort of Spanish postmenopausal women created to study the risk factors of osteoporotic fracture&#44; the mean TBS lies within microarchitecture degradation scores and is related to several clinical and anthropometric factors such as age&#44; weight&#44; height&#44; BMD&#44; a history of frailty fracture&#44; glucocorticoid treatment and the presence of DM2&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">TBS is a new technique that measures bone texture parameters that are extracted from DXA studies of the lumbar spine and provides an indirect index of the trabecular bone microarchitecture&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9&#44;15</span></a> It has been suggested that TBS could also be a complementary technique for BMD quantification using DXA to better estimate the risk of fracture&#44; especially in individuals with normal or osteopenic densitometry values&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">4&#44;7</span></a> given that TBS could theoretically provide additional information on bone quality not reflected in the BMD&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The clinical studies in Spain on TBS have confirmed its usefulness in certain patient groups&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">14&#44;17&#8211;19</span></a> In this study of 2510 postmenopausal women&#44; which excluded those with a BMI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> &#40;the increase in abdominal fat can distort the TBS results&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">15</span></a> the values of this index are inversely related to age&#44; weight and height and positively related to BMD&#44; as has been reported in most population studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9&#44;24&#44;25</span></a> These studies have shown similar results in terms of the intensity of the association between TBS and age&#44; while the positive relationship with BMD varies according to the anatomical region studied and the participant&#39;s epidemiological characteristics&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">With regard to the clinical variables&#44; a history of a frailty fracture was significantly associated with a lower TBS&#44; both in the univariate and multivariate analysis&#46; Furthermore&#44; most of the women with a history of fractures had a degraded TBS&#44; and in fact only 18&#37; of these had normal values&#46; Although the relationship between TBS and BMD and&#47;or lumbar <span class="elsevierStyleItalic">T</span> score was weakly positive&#44; most of the patients with densitometric osteoporosis &#40;approximately 71&#37;&#41; had a degraded microarchitecture&#44; a finding that was also observed in 50&#37; of the women with osteopenia&#46; This suggests that TBS could provide complementary information for assessing the risk of fracture in this population group&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">26&#44;27</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">It is noteworthy that the TBS for the women with DM2 were significantly lower than those of the participants without this disease&#46; In recent years&#44; an increase has been reported in the risk of fractures in patients with diabetes&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a> However&#44; these patients usually present relatively higher BMD values than expected based on the actual rate of fractures&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a> This fact suggests that there are other mechanisms&#44; which are not reflected in the BMD&#44; that are involved in the increase in bone frailty of patients with diabetes&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a> Similar to our findings&#44; recent studies have shown a reduction in TBS in this population group and have suggested that it could be a useful technique in identifying patients with a risk of fractures&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">30</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The participants who were taking glucocorticoids also had significantly lower TBS than those who were not taking them&#46; The consumption of glucocorticoids is the most common cause of secondary osteoporosis and entails an increase in the risk of fractures&#44; mainly vertebral&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">31</span></a> The pathogenesis of corticosteroid osteoporosis is complex and has been related to several factors such as the underlying disease&#44; the patients&#8217; clinical characteristics&#44; the dosage and treatment time&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">31&#44;32</span></a> The pathophysiology is multifactorial and is associated with a pronounced reduction in bone formation&#44; which leads to reduced bone mass&#44; along with a deterioration in other qualitative aspects of bone tissue that increase its frailty&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">31</span></a> In this respect&#44; and similar to what happens for patients with diabetes&#44; patients treated with glucocorticoids have fractures with relatively high BMD values&#44; which impedes their preventive treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a> In agreement with our results&#44; other authors have reported a reduction in TBS in patients who take glucocorticoids&#44; indicating that this imaging technique could be beneficial in this population subgroup for identifying patients with an increased risk of fracture&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">15&#44;16</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">This study has strengths and limitations&#46; Its strengths include the sample size&#44; the cohort&#39;s populational nature and the confirmation of the main associations of TBS in a Spanish population with osteoporosis&#46; The limitations are those inherent in a cohort study that analyzes in a cross-sectional manner the results of a new technique&#46; The study might have selection or baseline and longitudinal biases that could affect its results&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">In conclusion&#44; in the FRODOS cohort composed of women between the ages of 59 and 70 years&#44; the TBS was mostly located in the degraded microarchitecture category&#44; in relation to aging and reduced BMD&#46; Low TBS were more common in the participants with a history of fracture&#44; those who had undergone glucocorticoid treatment and those who had DM2&#46; These results&#44; consistent with recent studies&#44; suggest that this index could be a useful tool for assessing the risk of osteoporotic fracture&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Funding</span><p id="par0130" class="elsevierStylePara elsevierViewall">This project was partly funded by the Ministry of Science and Innovation &#8211; Health Institute Carlos <span class="elsevierStyleSmallCaps">III</span>&#8211; PI10&#47;00034 and by the Spanish Society for Bone and Mineral Metabolism Research &#8211; Project SEIOMM &#8211; TBS 2014&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicts of interest</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "xres1009451"
          "titulo" => "Abstract"
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            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction and objectives"
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              "titulo" => "Materials and methods"
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          "titulo" => "Keywords"
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          "titulo" => "Resumen"
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              "titulo" => "Introducci&#243;n y objetivos"
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              "titulo" => "Material y m&#233;todos"
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              "titulo" => "Resultados"
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          "titulo" => "Palabras clave"
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          "titulo" => "Background"
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          "titulo" => "Materials and methods"
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            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Densitometry"
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            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Evaluation of the trabecular bone score"
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              "titulo" => "Statistical analysis"
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    "fechaRecibido" => "2017-09-04"
    "fechaAceptado" => "2017-12-14"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec968988"
          "palabras" => array:3 [
            0 => "Bone mineral density"
            1 => "Fractures"
            2 => "Osteoporosis"
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      ]
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec968989"
          "palabras" => array:3 [
            0 => "Densidad mineral &#243;sea"
            1 => "Fracturas"
            2 => "Osteoporosis"
          ]
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    "resumen" => array:2 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The trabecular bone score &#40;TBS&#41; is an imaging technique that assesses the condition of the trabecular microarchitecture&#46; Preliminary results suggest that TBS&#44; along with the bone mineral density assessment&#44; could improve the calculation of the osteoporotic fracture risk&#46; The aim of this study was to analyze TBS values and their relationship with the clinical characteristics&#44; bone mineral density and history of fractures of a cohort of posmenopausal women&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We analyzed 2257 posmenopausal women from the FRODOS cohort&#44; which was created to determine the risk factors for osteoporotic fracture through a clinical survey and bone densitometry with vertebral morphometry&#46; TBS was applied to the densitometry images&#46; TBS values &#8804;1230 were considered indicative of degraded microarchitecture&#46; We performed a simple and multiple linear regression to determine the factors associated with this index&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean TBS value in L1&#8211;L4 was 1&#46;203<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;121&#46; Some 55&#46;3&#37; of the women showed values indicating degraded microarchitecture&#46; In the multiple linear regression analysis&#44; the factors associated with low TBS values were age&#44; weight&#44; height&#44; spinal <span class="elsevierStyleItalic">T</span>-score&#44; glucocorticoid treatment&#44; presence of type 2 diabetes and a history of fractures due to frailty&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">TBS showed microarchitecture degradation values in the participants of the FRODOS cohort and was associated with anthropometric factors&#44; low bone mineral density values&#44; the presence of fractures&#44; a history of type 2 diabetes mellitus and the use of glucocorticoids&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0005"
            "titulo" => "Introduction and objectives"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
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          2 => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El <span class="elsevierStyleItalic">Trabecular Bone Score</span> &#40;TBS&#41; es una t&#233;cnica de imagen que eval&#250;a el estado de la microarquitectura trabecular&#46; Resultados preliminares sugieren que&#44; junto a la valoraci&#243;n de la densidad mineral &#243;sea&#44; podr&#237;a mejorar la estimaci&#243;n del riesgo de fractura ostopor&#243;tica&#46; El objetivo de este estudio fue analizar los valores de TBS y su relaci&#243;n con las caracter&#237;sticas cl&#237;nicas&#44; densidad mineral &#243;sea y antecedentes de fracturas en una cohorte de mujeres posmenop&#225;usicas&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Analizamos 2&#46;257 mujeres posmenop&#225;usicas procedentes de la cohorte FRODOS&#44; constituida para determinar los factores de riesgo de fractura osteopor&#243;tica mediante una encuesta cl&#237;nica y densitometr&#237;a &#243;sea con morfometr&#237;a vertebral&#46; Se aplic&#243; el TBS a las im&#225;genes densitom&#233;tricas&#46; Valores de TBS &#8804;1&#44;230 se consideraron indicativos de microarquitectura degradada&#46; Se realiz&#243; una regresi&#243;n lineal simple y m&#250;ltiple para determinar los factores asociados con este &#237;ndice&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El valor medio de TBS en L1-L4 fue de 1&#44;203<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;121&#46; El 55&#44;3&#37; de las mujeres presentaban valores de microarquitectura degradada&#46; En el an&#225;lisis de regresi&#243;n lineal m&#250;ltiple los factores asociados a los valores bajos de TBS fueron la edad&#44; el peso&#44; la altura&#44; escala T de columna lumbar&#44; tratamiento con glucocorticoides&#44; presencia de diabetes tipo 2 y antecedentes de fractura por fragilidad&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El TBS mostr&#243; valores de microarquitectura degradada en las participantes de la cohorte FRODOS y se asoci&#243; a factores antropom&#233;tricos&#44; valor bajo de densidad mineral &#243;sea&#44; presencia de fracturas&#44; antecedentes de diabetes mellitus tipo 2 y uso de glucocorticoides&#46;</p></span>"
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            "titulo" => "Material y m&#233;todos"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as&#58; Redondo L&#44; Puigoriol E&#44; Rodr&#237;guez JR&#44; Peris P&#44; Kanterewicz E&#46; Utilidad del <span class="elsevierStyleItalic">Trabecular Bone Score</span> en la valoraci&#243;n del riesgo de fractura osteopor&#243;tica&#46; Rev Clin Esp&#46; 2018&#59;218&#58;121&#8211;127&#46;</p>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">FRODOS cohort diagram&#46;</p>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Trabecular bone score and bone mineral density&#46; &#40;a&#41; A TBS according to the densitometric categories&#46; &#40;b&#41; Correlation between TBS and lumbar T scale in women with frailty fractures&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The values are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviation</span>&#58; BMD&#44; bone mineral density&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2257&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Weight&#44; kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Height&#44; cm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">155&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fracture in postmenopause</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">430 &#40;19&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Prevalence of vertebral fractures</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90 &#40;4&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Frailty fractures</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">482 &#40;21&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Glucocorticoid treatment</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">121 &#40;5&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">199 &#40;8&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lumbar BMD&#44; g&#47;cm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;990<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lumbar spine T score</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">425 &#40;18&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Osteopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1158 &#40;51&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">430 women with fractures in postmenopause&#44; 90 women with prevalence of vertebral fractures of which 38 &#40;1&#46;7&#37;&#41; are cases of coinciding fractures&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics of the study population&#46;</p>"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; BMD&#44; bone mineral density&#59; TBS&#44; trabecular bone score&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">TBS values &#8211; clinical variables<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TBS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Fracture in postmenopause</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;208<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;179<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Prevalence of vertebral fractures</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;204<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;161<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Frailty fractures</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;210<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#60;&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;176<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Glucocorticoid treatment</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;205<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;167<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Diabetes</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;208<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#60;&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;150<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">BMD</td><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;245<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">&#60;&#46;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Osteopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Osteoporosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;157<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Coefficients of correlation TBS &#8211; anthropometric and densitometric variables<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a></th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#961;</span> Pearson correlation coefficient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;203&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;193&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar BMD&#44; g&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;262&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar spine <span class="elsevierStyleItalic">T</span> score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;261&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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            1 => array:3 [
              "identificador" => "tblfn0015"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Pearson correlation coefficient&#46;</p> <p class="elsevierStyleNotepara" id="npar0020">The tests were considered statistically significant when <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46;</p>"
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; BMD&#44; bone mineral density&#59; CI&#44; confidence interval&#59; DM2&#44; type 2 diabetes mellitus&#59; TBS&#44; trabecular bone score&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TBS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span> &#40;95&#37; CI&#41; univariate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span> &#40;95&#37; CI&#41; multivariate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;007 &#40;&#8722;0&#46;008&#59; &#8722;0&#46;005&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;005 &#40;&#8722;0&#46;007&#59; &#8722;0&#46;004&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;003 &#40;&#8722;0&#46;004&#59; &#8722;0&#46;002&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;003 &#40;&#8722;0&#46;004&#59; &#8722;0&#46;003&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;002 &#40;&#8722;0&#46;003&#59; &#8722;0&#46;002&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;003 &#40;&#8722;0&#46;004&#59; &#8722;0&#46;003&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar BMD&#44; g&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;196 &#40;0&#46;166&#59; 0&#46;226&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lumbar spine <span class="elsevierStyleItalic">T</span> score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;023 &#40;0&#46;020&#59; 0&#46;027&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;034 &#40;0&#46;030&#59; 0&#46;037&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucocorticoid treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;038 &#40;&#8722;0&#46;061&#59; &#8722;0&#46;016&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;036 &#40;&#8722;0&#46;056&#59; &#8722;0&#46;017&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DM2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;058 &#40;&#8722;0&#46;076&#59; &#8722;0&#46;041&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;063 &#40;&#8722;0&#46;079&#59; &#8722;0&#46;047&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fracture in postmenopause&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;030 &#40;&#8722;0&#46;043&#59; &#8722;0&#46;017&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prevalence of vertebral fractures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;043 &#40;&#8722;0&#46;069&#59; &#8722;0&#46;017&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Frailty fractures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;034 &#40;&#8722;0&#46;047&#59; &#8722;0&#46;022&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;019 &#40;&#8722;0&#46;030&#59; &#8722;0&#46;008&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:32 [
            0 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Osteoporosis prevention&#44; diagnosis and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "NIH&#44; consensus development panel on osteoporosis prevention&#44; diagnosis&#44; therapy"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Med Assoc"
                        "fecha" => "2001"
                        "volumen" => "285"
                        "paginaInicial" => "785"
                        "paginaFinal" => "795"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "WHO Study Group on Assessment of fracture risk and its application to screening for postmenopausal osteoporosis&#58; report of a WHO study group &#91;meeting held in Rome from 22 to 25 June 1992&#93;"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "1994"
                        "editorial" => "OMS&#46; Series de informes t&#233;cnicos 843&#46; Ginebra"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictive value of BMD for hip and other fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Johnell"
                            1 => "J&#46;A&#46; Kanis"
                            2 => "A&#46; Oden"
                            3 => "H&#46; Johansson"
                            4 => "C&#46; De Laet"
                            5 => "P&#46; Delmas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1359/JBMR.050304"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "2005"
                        "volumen" => "20"
                        "paginaInicial" => "1185"
                        "paginaFinal" => "1194"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15940371"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of age and bone mineral density on the absolute&#44; excess&#44; and relative risk of fracture in posmenopausal women aged 50&#8211;99&#59; results from the National Osteoporosis Risk Assessment &#40;NORA&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;S&#46; Siris"
                            1 => "S&#46;K&#46; Brenneman"
                            2 => "E&#46; Barrett-Connor"
                            3 => "P&#46;D&#46; Miller"
                            4 => "S&#46; Sajjan"
                            5 => "M&#46;L&#46; Berger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-005-0027-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2006"
                        "volumen" => "17"
                        "paginaInicial" => "565"
                        "paginaFinal" => "574"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16392027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Performance of risk instruments for predicting osteoporotic fracture risk&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Nayak"
                            1 => "D&#46;L&#46; Edwards"
                            2 => "A&#46;A&#46; Saleh"
                            3 => "S&#46;L&#46; Greenspan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-013-2504-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2014"
                        "volumen" => "25"
                        "paginaInicial" => "23"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24105431"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk assessment tools to identify women with increased risk of osteoporotic fracture&#58; complexity or simplicity&#63; A systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;H&#46; Rubin"
                            1 => "T&#46; Friis-Holmberg"
                            2 => "A&#46;P&#46; Hermann"
                            3 => "B&#46; Abrahamsen"
                            4 => "K&#46; Brixen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jbmr.1956"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "1701"
                        "paginaFinal" => "1717"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23592255"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What&#39;s in a name&#63; What constitutes the clinical diagnosis of osteoporosis&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;S&#46; Siris"
                            1 => "S&#46; Boonen"
                            2 => "P&#46;J&#46; Mitchell"
                            3 => "J&#46; Bilezikian"
                            4 => "S&#46; Silverman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-012-1991-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "2093"
                        "paginaFinal" => "2097"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22543575"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlations between grey-level variations in 2D projection images &#40;TBS&#41; and 3D microarchitecture&#58; applications in the study of human trabecular bone microarchitecture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Pothuaud"
                            1 => "P&#46; Carceller"
                            2 => "D&#46; Hans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bone.2007.11.018"
                      "Revista" => array:6 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2008"
                        "volumen" => "42"
                        "paginaInicial" => "775"
                        "paginaFinal" => "787"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18234577"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trabecular Bone Score TBS&#58; available knowledge&#44; clinical relevance&#44; and future prospects"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "the Scientific Committee of the GRIO &#40;Groupe de Recherche et d&#8217;information sur les Ost&#233;oporsoses&#41;"
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46; Bousson"
                            1 => "C&#46; Bergot"
                            2 => "B&#46; Sutter"
                            3 => "P&#46; Levitz"
                            4 => "B&#46; Cortet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-011-1824-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "1489"
                        "paginaFinal" => "1501"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22083541"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cl&#237;nical factors associated with Trabecular Bone Score"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46;D&#46; Leslie"
                            1 => "M&#46;A&#46; Krieg"
                            2 => "D&#46; Hans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jocd.2013.01.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Densitom"
                        "fecha" => "2013"
                        "volumen" => "16"
                        "paginaInicial" => "374"
                        "paginaFinal" => "379"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23452869"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Added value of Trabecular Bone Score to bone mineral density for prediction of osteoporotic fractures in posmenopausal women&#58; the OPUS study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Briot"
                            1 => "S&#46; Paternotte"
                            2 => "S&#46; Kolta"
                            3 => "R&#46; Eastell"
                            4 => "D&#46;M&#46; Reid"
                            5 => "D&#46; Felsenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2013"
                        "volumen" => "57"
                        "paginaInicial" => "231"
                        "paginaFinal" => "236"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density&#58; the Manitoba study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Hans"
                            1 => "A&#46;L&#46; Goertzen"
                            2 => "M&#46;A&#46; Krieg"
                            3 => "W&#46;D&#46; Leslie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jbmr.499"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "2011"
                        "volumen" => "26"
                        "paginaInicial" => "2762"
                        "paginaFinal" => "2769"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21887701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of the potential use of Trabecular Bone Score to complement bone mineral density in the diagnosis of osteoporosis&#58; a preliminary spine BMD-matched&#44; case-control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Pothuaud"
                            1 => "N&#46; Barthe"
                            2 => "M&#46;A&#46; Krieg"
                            3 => "N&#46; Mehsen"
                            4 => "P&#46; Carceller"
                            5 => "D&#46; Hans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jocd.2008.11.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Densitom"
                        "fecha" => "2009"
                        "volumen" => "12"
                        "paginaInicial" => "170"
                        "paginaFinal" => "176"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19181553"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is bone microarchitecture status of the lumbar spine assessed by TBS related to femoral neck fracture&#63; A Spanish case&#8211;control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;M&#46; Del Rio"
                            1 => "R&#46; Winzenrieth"
                            2 => "C&#46; Cormier"
                            3 => "S&#46;D&#46; Gregorio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-012-2008-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2013"
                        "volumen" => "24"
                        "paginaInicial" => "991"
                        "paginaFinal" => "998"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22581295"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trabecular Bone Score&#58; a noninvasive analytical method based upon the DXA image"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;C&#46; Silva"
                            1 => "W&#46;D&#46; Leslie"
                            2 => "H&#46; Resch"
                            3 => "O&#46; Lamy"
                            4 => "O&#46; Lesnyak"
                            5 => "N&#46; Binkley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Min Res"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "518"
                        "paginaFinal" => "530"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trabecular Bone Score reflects trabecular microarchitecture deterioration and fragility fracture in female adult patients receiving glucocorticoid therapy&#58; a pre-post controlled study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;H&#46; Chuang"
                            1 => "T&#46;L&#46; Chuang"
                            2 => "M&#46; Koo"
                            3 => "Y&#46;F&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2017/4210217"
                      "Revista" => array:5 [
                        "tituloSerie" => "Biomed Res Int"
                        "fecha" => "2017"
                        "volumen" => "2017"
                        "paginaInicial" => "4210217"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28127556"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "TBS and BMD at the end of AI-therapy&#58; a prospective study of the B-ABLE cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Rodr&#237;guez"
                            1 => "M&#46; Pineda"
                            2 => "S&#46; Servitja"
                            3 => "Garcia N"
                            4 => "T&#46; Martos"
                            5 => "I&#46; Tusquets"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bone.2016.08.008"
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                        "tituloSerie" => "Bone"
                        "fecha" => "2016"
                        "volumen" => "92"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27519968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0250"
              "etiqueta" => "18"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone density&#44; microarchitecture&#44; and tissue quality after long-term treatment with tenofovir&#47;emtricitabine or abacavir&#47;lamivudine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; G&#252;erri-Fern&#225;ndez"
                            1 => "D&#46; Molina-Morant"
                            2 => "J&#46; Villar-Garc&#237;a"
                            3 => "S&#46; Herrera"
                            4 => "A&#46; Gonz&#225;lez-Mena"
                            5 => "A&#46; Guelar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/QAI.0000000000001396"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Acquir Immune Defic Syndr"
                        "fecha" => "2017"
                        "volumen" => "75"
                        "paginaInicial" => "322"
                        "paginaFinal" => "327"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28418990"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison between different bone treatments on areal bone mineral density &#40;aBMD&#41; and bone microarchitectural texture as assessed by the Trabecular Bone Score &#40;TBS&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Di Gregorio"
                            1 => "L&#46; del Rio"
                            2 => "J&#46; Rodriguez-Tolra"
                            3 => "E&#46; Bonel"
                            4 => "M&#46; Garc&#237;a"
                            5 => "R&#46; Winzenrieth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bone.2014.12.062"
                      "Revista" => array:6 [
                        "tituloSerie" => "Bone"
                        "fecha" => "2015"
                        "volumen" => "75"
                        "paginaInicial" => "138"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25571842"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relaci&#243;n del telop&#233;ptido carboxiterminal del col&#225;geno tipo I s&#233;rico con la densidad mineral &#243;sea y el consumo de f&#225;rmacos en mujeres posmenop&#225;usicas Datos preliminares del estudio FRODOS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Kanterewicz"
                            1 => "E&#46; Puigoriol"
                            2 => "P&#46; Peris"
                            3 => "L&#46; del Rio"
                            4 => "P&#46; Rosique"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2009"
                        "volumen" => "133"
                        "paginaInicial" => "609"
                        "paginaFinal" => "614"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Distribution of serum bCTX in a population-based study of posmenopausal women taking into account different anti-osteoporotic therapies &#40;the FRODOS cohort&#41;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "FRODOS Research Group"
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Kanterewicz"
                            1 => "P&#46; Peris"
                            2 => "E&#46; Puigoriol"
                            3 => "A&#46; Ya&#241;ez"
                            4 => "P&#46; Rosique"
                            5 => "L&#46; del Rio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00774-012-0410-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Metab"
                        "fecha" => "2013"
                        "volumen" => "31"
                        "paginaInicial" => "231"
                        "paginaFinal" => "239"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23223942"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of vertebral fractures and minor vertebral deformities evaluated by DXA-assisted vertebral fracture assessment &#40;VFA&#41; in a population-based study of postmenopausal women&#58; the FRODOS study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Kanterewicz"
                            1 => "E&#46; Puigoriol"
                            2 => "J&#46; Garc&#237;a-Barrionuevo"
                            3 => "L&#46; del Rio"
                            4 => "M&#46; Casellas"
                            5 => "P&#46; Peris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-014-2628-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2014"
                        "volumen" => "25"
                        "paginaInicial" => "1455"
                        "paginaFinal" => "1464"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24599272"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A meta-analysis of Trabecular Bone Score in fracture risk prediction and its relationship to FRAX"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;V&#46; McCloskey"
                            1 => "A&#46; &#211;den"
                            2 => "N&#46;C&#46; Harvey"
                            3 => "W&#46;D&#46; Leslie"
                            4 => "D&#46; Hans"
                            5 => "H&#46; Johansson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jbmr.2734"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "2016"
                        "volumen" => "31"
                        "paginaInicial" => "940"
                        "paginaFinal" => "948"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26498132"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trabecular bone score in healthy ageing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Bazzocchi"
                            1 => "F&#46; Ponti"
                            2 => "D&#46; Diano"
                            3 => "M&#46; Amadori"
                            4 => "U&#46; Albisinni"
                            5 => "G&#46; Battista"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1259/bjr.20140865"
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Radiol"
                        "fecha" => "2015"
                        "volumen" => "88"
                        "paginaInicial" => "20140865"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26148778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Generation and validation of a normative&#44; age-specific reference curve for lumbar spine trabecular bone score &#40;TBS&#41; in French women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Dufour"
                            1 => "R&#46; Winzenrieth"
                            2 => "A&#46; Heraud"
                            3 => "D&#46; Hans"
                            4 => "N&#46; Mehsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-013-2384-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2013"
                        "volumen" => "24"
                        "paginaInicial" => "2837"
                        "paginaFinal" => "2846"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23681084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adjusting fracture probability by Trabecular Bone Score"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;V&#46; McCloskey"
                            1 => "A&#46; Od&#233;n"
                            2 => "N&#46;C&#46; Harvey"
                            3 => "W&#46;D&#46; Leslie"
                            4 => "D&#46; Hans"
                            5 => "H&#46; Johansson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00223-015-9980-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Calcif Tissue Int"
                        "fecha" => "2015"
                        "volumen" => "96"
                        "paginaInicial" => "500"
                        "paginaFinal" => "509"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25796374"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
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              "etiqueta" => "27"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Trabecular Bone Score &#40;TBS&#41; predicts vertebral fractures in Japanese women over 10 years independently of bone density and prevalent vertebral deformity&#58; the Japanese population-based osteoporosis &#40;JPOS&#41; cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "J&#46; Tamaki"
                            2 => "E&#46; Kadowaki"
                            3 => "Y&#46; Sato"
                            4 => "N&#46; Dongmei"
                            5 => "R&#46; Winzenrieth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jbmr.2048"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Miner Res"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "399"
                        "paginaFinal" => "407"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23873699"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "28"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Type 2 diabetes and the skeleton&#58; new insights into sweet bones"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46;V&#46; Shanbhogue"
                            1 => "D&#46;M&#46; Mitchell"
                            2 => "C&#46;J&#46; Rosen"
                            3 => "M&#46;L&#46; Bouxsein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2213-8587(15)00283-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Diabetes Endocrinol"
                        "fecha" => "2016"
                        "volumen" => "4"
                        "paginaInicial" => "159"
                        "paginaFinal" => "173"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26365605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0305"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes &#8211; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Vestergaard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00198-006-0253-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2007"
                        "volumen" => "18"
                        "paginaInicial" => "427"
                        "paginaFinal" => "444"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17068657"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "30"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trabecular Bone Score &#40;TBS&#41; and TBS-adjusted fracture risk assessment tool are potential supplementary tools for the discrimination of morphometric vertebral fractures in posmenopausal women with type 2 diabetes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;J&#46; Choi"
                            1 => "S&#46;Y&#46; Ock"
                            2 => "Y&#46;S&#46; Chung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jocd.2016.04.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Densitom"
                        "fecha" => "2016"
                        "volumen" => "19"
                        "paginaInicial" => "507"
                        "paginaFinal" => "514"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27130256"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Glucocorticoid-induced osteoporosis&#58; pathophysiology and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Canalis"
                            1 => "G&#46; Mazziotti"
                            2 => "A&#46; Giustina"
                            3 => "J&#46;P&#46; Bilezikian"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1007/s00198-007-0394-0"
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                        "tituloSerie" => "Osteoporos Int"
                        "fecha" => "2007"
                        "volumen" => "18"
                        "paginaInicial" => "1319"
                        "paginaFinal" => "1328"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17566815"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46;P&#46; Van Staa"
                            1 => "R&#46;F&#46; Laan"
                            2 => "I&#46;P&#46; Barton"
                            3 => "S&#46; Cohen"
                            4 => "D&#46;M&#46; Reid"
                            5 => "C&#46; Cooper"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1002/art.11283"
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                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2003"
                        "volumen" => "48"
                        "paginaInicial" => "3224"
                        "paginaFinal" => "3229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14613287"
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Article information

ISSN: 22548874
Original language: English

DOI:10.1016/j.rceng.2017.12.002

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