骨小梁分值 (TBS) 是一种灰度级纹理指标，已被证明与多种骨质疏松症的骨折风险相关。TBS 在预测骨折和骨活性药物对催产素酶抑制剂 (AIs) 诱导的骨质疏松症的 TBS 的影响仍然大部分未知。这项回顾性研究的主要目标是评估登奈普单抗和双磷酸盐 (BPs) 对 AIs 暴露的妇女的 TBS 和椎体骨折 (VFs) 的影响。评估241例连续的妇女 (中位年龄58岁)，这些妇女患有早期乳腺癌，正在接受 AIs 治疗，评估其基线和随访18-24个月后的 TBS、骨密度 (BMD) 和形态学 VFs。在研究期间，139名妇女(57.7%) 每隔6个月接受一次登奈普单抗60毫克，53名妇女(22.0%) 接受双磷酸盐治疗，而49名妇女(20.3%) 未接受骨活性药物治疗。登奈普单抗显著增加了 TBS 值 (从1.270增加到1.323; P < 0.001)，伴有椎体骨折风险显著减少 (比值比 0.282; P = 0.021)。在双磷酸盐治疗期间，TBS 没有显著变化 (P = 0.849)，与未接受骨活性药物治疗的妇女相比，骨折发生率也没有显著差异 (P = 0.427)。在整个人群中，患有新发生 VFs 的妇女与非骨折妇女相比 TBS 下降更明显 (P = 0.003)，任何骨骼部位的 BMD 变化无显著差异。TBS 变化预测 AIs 治疗的妇女的骨折风险。登奈普单抗能够有效提高 TBS，并降低椎体骨折风险。© 2023作者，意大利内分泌学会 (SIE) 授权专用。

Trabecular bone score (TBS) is a gray-level textural metric that has shown to correlate with risk of fractures in several forms of osteoporosis. The value of TBS in predicting fractures and the effects of bone-active drugs on TBS in aromatase inhibitors (AIs)-induced osteoporosis are still largely unknown. The primary objective of this retrospective study was to assess the effects of denosumab and bisphosphonates (BPs) on TBS and vertebral fractures (VFs) in women exposed to AIs.241 consecutive women (median age 58 years) with early breast cancer undergoing treatment with AIs were evaluated for TBS, bone mineral density (BMD) and morphometric VFs at baseline and after 18-24 months of follow-up. During the study period, 139 women (57.7%) received denosumab 60 mg every 6 months, 53 (22.0%) BPs, whereas 49 women (20.3%) were not treated with bone-active drugs.Denosumab significantly increased TBS values (from 1.270 to 1.323; P < 0.001) accompanied by a significant decrease in risk of VFs (odds ratio 0.282; P = 0.021). During treatment with BPs, TBS did not significantly change (P = 0.849) and incidence of VFs was not significantly different from women untreated with bone-active drugs (P = 0.427). In the whole population, women with incident VFs showed higher decrease in TBS vs. non-fractured women (P = 0.003), without significant differences in changes of BMD at any skeletal site.TBS variation predicts fracture risk in AIs treated women. Denosumab is effective to induce early increase of TBS and reduction in risk of VFs.© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).