Longitudinal changes in bone mineral density and trabecular bone score in Korean adults: a community-based prospective study

Summary The bone mineral densities (BMDs) of the femoral neck and total hip, and the lumbar spine trabecular bone score (TBS), tended to decrease with age in both men and women, whereas the lumbar spine BMD tended to increase. Lumbar spine BMD is thus inappropriate for evaluating longitudinal changes in bone loss; the lumbar spine TBS is an alternative measure. Purpose Aging is associated with a decrease in bone mass and quality. This community-based prospective cohort study investigated longitudinal changes in bone phenotype in Korean adults. Methods We analyzed data from a prospective community-based cohort study, the Korean Genome and Epidemiology Study. Postmenopausal women and men who underwent dual-energy X-ray absorptiometry at least twice from 2007 to 2014 were included. Longitudinal changes in bone mineral density (BMD) and trabecular bone score (TBS) over 6 years were analyzed by sex, age, and body mass index. Results A total of 1895 subjects were enrolled (men 965; postmenopausal women 929). The femoral neck (FN) BMD, total hip (TH) BMD, and lumbar spine (LS) TBS decreased significantly over time, but the LS BMD increased significantly. In men, the average annual changes were 0.3% in LS BMD ( p < 0.001), − 0.33% in FN BMD ( p < 0.001), − 0.26% in TH BMD ( p = 0.001), and − 0.27% in LS TBS ( p < 0.001). In women, the average annual changes were 0.27% in LS BMD ( p < 0.001), − 0.67% in FN BMD ( p < 0.001), − 0.66% in TH BMD ( p < 0.001), and − 0.27% in LS TBS ( p < 0.001). The longitudinal decrease in TH BMD over time was significantly greater in women (versus men) and those who were older (versus younger). Conclusion The FN and TH BMDs decreased with aging. But, the LS BMD was inappropriate to evaluate longitudinal changes of bone loss. The LS TBS could be alterative.