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Trabecular bone score (TBS) and bone mineral density in patients with long-term therapy with warfarin

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Abstract

Summary

In this study, we compared patients using the anticoagulant warfarin for more than a year with a control group with similar characteristics but without using the drug. We demonstrated worse BMD and bone quality by trabecular bone score (TBS) in patients using warfarin for more than 1 year.

Purpose

Evaluate the bone mineral density (BMD) and the trabecular bone score (TBS) of patients taking warfarin for more than 1 year compared with a control group.

Methods

Male patients aged 25–65 years in warfarin use for more than 1 year were included. Patients answered a questionnaire regarding lifestyle habits and realized a dual X-ray densitometry (DXA) (lumbar spine and hip), and TBS was evaluated.

Results

From the 96 patients invited, 33 patients accepted to participate and comprised the warfarin group (WG), and 3 were excluded. The control group (CG) was composed of 21 individuals matched by age and race. The mean age of WG was 57.0 ± 7.6 and in the CG 54.0 ± 10.6 years (p = 0.095). The BMD in WG was lower than that in the CG in all sites (spine p < 0.001, total hip p = 0.001, and femoral neck p = 0.005). A longer time of warfarin use increased the likelihood of having low BMD (OR = 1.239, CI 1.064–1.674, p = 0.01), whereas high BMI decreased it (OR = 0.732, CI 0.533–0.918, p = 0.03). The TBS was lower in WG than the CG (p = 0.04). Lower TBS was associated with hypertension in both groups and to the hip BMD (neck and total) (p < 0.005) in the WG. In the multivariate analysis, only hypertension (− 0.10, CI − 0.17 to − 0.03, p = 0.008) and total hip BMD ( 0.26, CI 0.07–0.46, p = 0.009) influenced TBS.

Conclusion

We demonstrated an association between worsening of BMD and bone quality in patients taking warfarin for more than 1 year.

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Authors and Affiliations

  1. Endocrine Division (SEMPR), Hospital de Clínicas da Universidade Federal do Paraná , Av. Agostinho Leão Junior, 285 - Alto da Glória, Curitiba, PR, 80030-110, Brazil

    Júlia Vieira Oberger Marques, Carolina A. Moreira & Victoria Zeghbi Cochenski Borba

  2. Cardiology Division, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, Brazil

    Jeferson Zanovelli Nalevaiko & Gustavo Lenci Marques

  3. Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil

    Matheus Felipe Oliveira & Arthur William Passos Raetsch

  4. Sector of Health Sciences, Medical School, Universidade Federal do Paraná, Curitiba, PR, Brazil

    Ricardo Rasmussen Petterle

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  1. Júlia Vieira Oberger Marques
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  2. Jeferson Zanovelli Nalevaiko
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  3. Matheus Felipe Oliveira
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  8. Victoria Zeghbi Cochenski Borba
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Correspondence to Júlia Vieira Oberger Marques.

Ethics declarations

The study was approved by the ethics committee on human research at our institution (84042318.2.0000.0096), and all patients signed an informed consent form (ICF).

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Marques, J.V.O., Nalevaiko, J.Z., Oliveira, M.F. et al. Trabecular bone score (TBS) and bone mineral density in patients with long-term therapy with warfarin. Arch Osteoporos 15, 102 (2020). https://doi.org/10.1007/s11657-020-00770-z

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