Aims: Although Trabecular Bone Score (TBS) is an established predictor of fracture risk, evidence in Australian populations remains limited (1). We investigated whether TBS was independently associated with minimal trauma fracture (MTF) and associated with body composition and anthropometric measures, in women attending a re-fracture prevention clinic in the Central Coast of New South Wales.
Methods: We conducted a retrospective study of 118 treatment-naïve women attending a re-fracture prevention clinic between 2023 and 2026 who underwent DXA with TBS and body composition assessment. Fractures were classified as MTF or more-than-minimal trauma (MT-MTF).
Results: The cohort comprised 118 Caucasian women, mean age 63.7 ± 6.0 years. 77 (65%) sustained an MTF and 41 (35%) a more-than-minimal trauma fracture (MT-MTF). Mean TBS was 1.33 ± 0.12 and was significantly lower in MTF than MT-MTF (1.30 vs 1.38, p < 0.001). In logistic regression analyses, partially degraded and degraded TBS, compared with normal TBS, were associated with increased odds of MTF (OR 4.31, 95% CI 1.76–10.52, p = 0.001; and OR 15.50, 95% CI 1.91–125.58, p = 0.010). These associations remained significant after adjustment for age and proximal femur BMD (adjusted OR 3.63, 95% CI 1.44–9.15, p = 0.006; and adjusted OR 12.95, 95% CI 1.53–109.50, p = 0.019). TBS was not associated with age, weight, skeletal muscle mass, body fat or fat distribution. TBS was inversely correlated with height (r = −0.389, p < 0.001), and this association persisted after excluding women with vertebral fractures.
Conclusion: In this Australian cohort, lower TBS was independently associated with MTF vs MT-MTF after adjustment for age and BMD, supporting its value as a marker of MTF risk. The inverse association between TBS and height may represent height loss in the MTF group. Unlike some international cohorts, TBS was not associated with body composition measures (2,3).