P4A087: Trabecular Bone Score Reference Values for Mexican Children and Adolescents

Background: Trabecular Bone Score (TBS) is a texture-based tool that analyzes DXA images to assess bone microarchitecture in the lumbar region. In pediatric population, definition of reference values has only been made in limited studies. The availability of TBS reference values in more children and adolescent populations may help to better understand better quality changes during childhood and adolescence.
Our objective was to determine TBS values in healthy Mexican children and adolescents reanalyzing DXA images obtained from a well-child study from which BMD reference values were obtained, among other data.

Methods: We included DXA acquisitions from 1585 clinically healthy children and adolescents (810 boys) aged 5 to 18 years old. TBS assessment was evaluated using a custom version of TBS (Med-Imaps SASU, France) that includes a soft tissue correction for pediatric subjects. We obtained means and standard deviations for each sex and age group and we constructed TBS age-related curves using GAMLSS in R Studio.

Results: Mean TBS values range from 1.057 to 1.278 in girls and from 1.083 to 1.291 in boys, from ages 5 to 18 in both cases. Smoothed curves for each sex show an increasing slope corresponding with puberty, in girls starting by age 8-9 and in boys by ate 10.

Conclusion: This is the first set of reference values for TBS in children and adolescents from Latin America to our best knowledge. Datasets and graphs like these may open the door for a wider use of TBS in pediatric population to improve diagnoses of bone diseases in these age groups.