scholarly journals Parathyroid Hormone-Related Changes of Bone Structure

2021 ◽  
pp. S3-S11
Author(s):  
M. Kužma ◽  
P. Jackuliak ◽  
Z. Killinger ◽  
J. Payer
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Trabecular Bone ◽  
Cortical Bone ◽  
Vertebral Fractures ◽  
Bone Structure ◽  
Trabecular Bone Score ◽  
Quantitative Computed Tomography ◽  
Indirect Measure ◽  
Increased Risk

Parathyroid hormone (PTH) increases the release of serum calcium through osteoclasts, which leads to bone resorption. Primary, PTH stimulates osteoblasts leading to increase RANKL (receptor activator for nuclear factor kappa-B ligand) expression and thus differentiation of osteoclasts. In kidneys, PTH increases calcium and decrease phosphate reabsorption. In kidneys, PTH stimulates 1alpha-hydroxylase to synthesize active vitamin D. Primary hyperparathyroidism (PHPT) is characterized by skeletal or renal complications. Nowadays, the classical form of PHPT is less seen and asymptomatic or subclinical (oligo symptomatic) forms are more frequent. Previously, it was thought that cortical bone is preferably affected by PHPT and that predispose bones to fracture at sites with a higher amount of cortical bone. However, an increased risk of vertebral fractures has been found by most of the studies showing that also trabecular bone is affected. Bone Mass measurement (BMD) at all skeletal sites is advised, but another specific tool for fracture assessment is needed. Trabecular bone score (TBS), an indirect measure of trabecular bone, maybe a useful method to estimate fracture risk. TBS is associated with vertebral fractures in PHPT regardless of BMD, age, BMI and gender. Furthermore, there is an association between TBS and high resolution peripheral quantitative computed tomography (HR-pQCT) parameters in the trabecular and cortical compartment. However, studies considering the effect of PHPT treatment on TBS are more conflicting. Secondary hyperparathyroidism caused by vitamin D deficiency was associated with impaired bone microarchitecture in all age categories, as measured by TBS and Hr-pQCT with further improvement after treatment with vitamin D.

scholarly journals Vitamin D deficiency is associated with cortical bone loss and fractures in the elderly

2019 ◽  
Vol 181 (5) ◽  
pp. 509-517 ◽  
Author(s):  
F P Paranhos-Neto ◽  
L Vieira Neto ◽  
M Madeira ◽  
A B Moraes ◽  
L M C Mendonça ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Loss ◽  
Vitamin D Deficiency ◽  
Cortical Bone ◽  
Vertebral Fractures ◽  
Elderly Women ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
X Rays ◽  
Cortical Bone Loss

Introduction The role of vitamin D on bone microarchitecture and fragility is not clear. Objective To investigate whether vitamin D deficiency (25(OH)D <20 ng/mL) increases cortical bone loss and the severity of fractures. Design Cross-sectional study of 287 elderly women with at least one prevalent low-impact fracture. Methods Biochemistry, X-rays to identify vertebral fractures (VFs) and to confirm non-vertebral fractures (NonVFs), and high-resolution peripheral quantitative computed tomography (HR-pQCT) to evaluate bone microstructure. Results Serum 25(OH)D levels were associated with body mass index (BMI: r = −0.161, P = 0.006), PTH (r = −0.165; P = 0.005), CTX (r = −0.119; P = 0.043) and vBMD at cortical bone (Dcomp: r = 0.132; P = 0.033) and entire bone (D100: r = 0.162 P = 0.009) at the distal radius, but not at the tibia. Age and PTH levels were potential confounding variables, but in the multiple linear regressions only BMI (95% CI: 0.11–4.16; P < 0.01), 25(OH)D (95% CI: −0.007 to 1.70; P = 0.05) and CTX (95% CI: −149.04 to 21.80; P < 0.01) predicted Dcomp, while BMI (95% CI: 1.13–4.18; P < 0.01) and 25(OH)D (95% CI: 0.24–1.52; P < 0.01) predicted D100. NonVFs predominated in patients with 25(OH)D <20 ng/mL (P = 0.013). Logistic regression analysis showed a decrease in the likelihood of presenting grade 2–3 VFs/NonVFs for every increase in 25(OH)D (OR = 0.962, 95% CI: 0.940–0.984; P = 0.001), BMI (OR = 0.932, 95% CI: 0.885–0.981; P = 0.007) and D100 at radius (OR = 0.994, 95% CI: 0.990–0.998; P = 0.005). Conclusion In elderly patients with prevalent fractures, vitamin D deficiency was associated with cortical bone loss and severity of fractures.

scholarly journals SAT-395 Correlations Between Biochemical Parameters and Trabecular Bone Score (TBS) in Primary Hyperparathyroidism (PHP) Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Lívia Marcela Santos ◽  
Monique Nakayama Ohe ◽  
Sthefanie Giovanna Pallone ◽  
Ilda Sizue Kunii ◽  
Renata Elen Costa Silva ◽  
...  
Keyword(s):  
Vitamin D ◽  
Trabecular Bone ◽  
Vitamin D Deficiency ◽  
Negative Correlation ◽  
Bone Structure ◽  
Trabecular Bone Score ◽  
Control Group ◽  
Total Calcium ◽  
Mineral Density ◽  
Positive Correlation

Abstract Background: Vitamin D deficiency is common among PHP patients. While data are limited, some studies suggest that vitamin D deficiency may exacerbates skeletal disease in PHP. TBS is a software-based method for assessment of trabecular bone structure of the spine, based on analysis of pixels obtained in dual energy x-ray absorptiometry (DXA) images. The aim of this study was to evaluate TBS, vitamin D status, clinical and laboratorial measurements in a PHP group of patients in a search for a more accurate bone fragility test for risk assessment in this group of patients. Methods: From June/2017 to January/2019, patients who met the criteria for PHP diagnosis were included in this study. Control group was composed by age and sex-matched healthy individuals. Overall, 64 PHP and 63 controls were enrolled. Bone mineral density (BMD) measured by DXA (Hologic QDR 4500) at the lumbar spine, total hip, femoral neck, and TBS values (InSight™) were determined in both groups. Total and ionized calcium, PTH, 25-hydroxyvitamin D (25(OH)D), creatinine, alkaline phosphatase, P1NP and CTX were measured. None were in use of Vitamin D supplementation. Results: As expected, PHP patients had lower BMD values than controls in all sites (p&lt;0.0001). TBS measurements were also reduced in PHP patients compared to controls (1233 vs 1280, p=0.0444). TBS values were inversely correlated with total calcium (CaT) and phosphorus measurements were positively correlated in the PHP patients. 25(OH)D measurements didn’t differ between groups (PHP 22.5 vs. controls 19.8 ng/mL, p=0.1699). There was a positive correlation between 25(OH)D and TBS in both PHP and controls (r= 0,3088, p= 0,0138 and r= 0,3708, p= 0,003 respectively). Considering individuals with vitamin D deficiency (25(OH)D levels &lt;=20 ng/mL), a negative correlation between TBS and CaT measurements among PHP patients (r= -0,4391, p=0,0172) was observeed, while in controls there was a positive correlation between TBS and 25(OH)D (r= 0,3504, p= 0,0362). Conclusion: Serum total calcium presents negative correlation and phosphorus a positive one with TBS in PHP patients. We also found a correlation between TBS and 25(OH)D, both in PHP and in controls. 25(OH)D &lt;=20 ng/mL is an independent risk factor determining degraded TBS among PHP patients and controls.

scholarly journals Osteocyte- and late Osteoblast-derived NOTUM Reduces Cortical Bone Mass in Mice

2021 ◽  
Author(s):  
Karin H. Nilsson ◽  
Petra Henning ◽  
Maha El Shahawy ◽  
Jianyao Wu ◽  
Antti Koskela ◽  
...  
Keyword(s):  
Bone Mass ◽  
Trabecular Bone ◽  
Cortical Bone ◽  
Vertebral Fractures ◽  
Volume Fraction ◽  
Substantial Reduction ◽  
Lumbar Vertebrae ◽  
Bone Homeostasis ◽  
Increased Risk ◽  
Cortical Bone Mass

Osteoporosis is a common skeletal disease, with increased risk of fractures. Currently available osteoporosis treatments reduce the risk of vertebral fractures, mainly dependent on trabecular bone, whereas the effect on non-vertebral fractures, mainly dependent on cortical bone, is less pronounced. WNT signaling is a crucial regulator of bone homeostasis, and the activity of WNTs is inhibited by NOTUM, a secreted WNT lipase. We previously demonstrated that conditional inactivation of NOTUM in all osteoblast lineage cells increases the cortical but not the trabecular bone mass. The aim of the present study was to determine if NOTUM increasing cortical bone is derived from osteoblast precursors/early osteoblasts or from osteocytes/late osteoblasts. First, we demonstrated Notum mRNA expression in Dmp1-expressing osteocytes and late osteoblasts in cortical bone using in situ hybridization. We then developed a mouse model with inactivation of NOTUM in Dmp1 expressing osteocytes and late osteoblasts (Dmp1-creNotumflox/flox mice). We observed that the Dmp1-creNotumflox/flox mice displayed a substantial reduction of Notum mRNA in cortical bone, resulting in increased cortical bone mass and decreased cortical porosity in femur, but no change in trabecular bone volume fraction (BV/TV) in femur or in the lumbar vertebrae L5 in Dmp1-creNotumflox/flox mice as compared to control mice. In conclusion, osteocytes and late osteoblasts are the principal source of NOTUM in cortical bone, and NOTUM derived from osteocytes/late osteoblasts reduces cortical bone mass. These findings demonstrate that inhibition of osteocyte/late osteoblast-derived NOTUM might be an interesting pharmacological target to increase cortical bone mass and reduce non-vertebral fracture risk.

scholarly journals Circulating miR-103a-3p and miR-660-5p are associated with bone parameters in patients with controlled acromegaly

2019 ◽  
Vol 8 (1) ◽  
pp. 39-49 ◽  
Author(s):  
Elena Valassi ◽  
Natalia García-Giralt ◽  
Jorge Malouf ◽  
Iris Crespo ◽  
Jaume Llauger ◽  
...  
Keyword(s):  
Vitamin D ◽  
Trabecular Bone Score ◽  
Structural Parameters ◽  
Quantitative Computed Tomography ◽  
Differentially Expressed ◽  
Cross Sectional ◽  
Negatively Associated ◽  
Bone Parameters ◽  
Increased Risk ◽  
Vitamin D Levels

Background Biochemical control of GH/IGF-I excess in acromegaly (ACRO) is associated with persistent impairment of trabecular microstructure leading to increased risk of vertebral fractures. Circulating miRNAs modulate the activity of osteoblasts and osteoclasts, and may be potential biomarkers of osteoporosis. Aims Identify differentially expressed miRNAs in the serum of patients with controlled ACRO vs controls and correlate miRNA levels with both biochemical and structural bone parameters. Patients and methods Twenty-seven patients with controlled ACRO (11 males, 16 females; mean age, 48 ± 5 years; BMI, 28 ± 4 kg/m2) and 27 age-, gender- and BMI-matched controls were recruited. Areal BMD at lumbar spine and femur, and trabecular bone score were assessed; volumetric BMD was measured by quantitative computed tomography QCT-Pro (Mindways). Twenty miRNAs, chosen by their putative role in bone, were quantified in serum using real-time qPCR. Results In ACRO patients, miR-103a-3p and miR-191-5p were found overexpressed, whereas miR-660-5p was underexpressed (P < 0.001). miR-103a-3p levels were negatively associated with both trabecular vBMD at trochanter and serum osteoprotegerin concentrations (P < 0.05) and positively with vitamin D concentrations (P < 0.01) and total cross-sectional area of the femoral neck (P < 0.05). miR-660-5p levels were correlated with both trabecular vBMD at trochanter and OPG concentrations (P < 0.05), but were negatively associated with vitamin D levels (P < 0.05). A negative correlation between miR-103-a-3p and miR-660-5p was found in both groups (P < 0.001). Conclusions Circulating miR-103a-3p and miR-660-5p are differentially expressed in controlled ACRO patients and associated with bone structural parameters. miRNAs may be one of the mechanisms involved in the pathogenesis of bone disease and could be used as biomarkers in ACRO patients.

scholarly journals DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Endocrine ◽  
2021 ◽  
Author(s):  
Enisa Shevroja ◽  
Francesco Pio Cafarelli ◽  
Giuseppe Guglielmi ◽  
Didier Hans
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Endocrine Disorders ◽  
Mineral Density ◽  
Increased Risk

AbstractOsteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

scholarly journals Cortical bone density by quantitative computed tomography mirrors disorders of bone structure in bone biopsy of non-dialysis CKD patients

Bone Reports ◽  
2022 ◽  
pp. 101166
Author(s):  
Amandha L. Bittencourt ◽  
Maria Eugênia F. Canziani ◽  
Larissa D.B.R. Costa ◽  
Carlos E. Rochitte ◽  
Aluizio B. Carvalho
Keyword(s):  
Computed Tomography ◽  
Bone Density ◽  
Cortical Bone ◽  
Bone Structure ◽  
Bone Biopsy ◽  
Quantitative Computed Tomography ◽  
Cortical Bone Density

scholarly journals The Trabecular Bone Score as a Predictor for Thalassemia-Induced Vertebral Fractures in Northeastern Thailand

Anemia ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Nattiya Teawtrakul ◽  
Sukanya Chukanhom ◽  
Suranut Charoensri ◽  
Charoonsak Somboonporn ◽  
Chatlert Pongchaiyakul
Keyword(s):  
Trabecular Bone ◽  
Vertebral Fractures ◽  
Trabecular Bone Score ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
X Ray ◽  
Bmd Testing ◽  
Northeastern Thailand

Introduction. Thalassemia bone disease is one of the disease-related complications in patients with thalassemia. Prevalence of fractures and the role of a trabecular bone score (TBS) as a predictive factor for fractures were evaluated in patients with thalassemia. Methods. A cross-sectional study was conducted in patients with thalassemia aged ≥18 years at Srinagarind Hospital, Khon Kaen University, Thailand. A lateral thoracolumbar radiograph and bone mineral density (BMD) at the lumbar spine and hip, as well as the TBS measured by dual-energy X-ray absorptiometry (DXA), were evaluated in all patients. Results. Among 86 patients, 14 patients were found to have radiographic vertebral fracture yielding a prevalence of 16.3%. All patients who had fractures were β-thalassemia/Hb E. Combined low BMD and TBS at lumbar spines and a presence of endocrinopathies were significantly associated with vertebral fractures. Conclusions. The prevalence of vertebral fractures in patients with thalassemia was not uncommon. A combined low BMD and TBS and a presence of endocrinopathies were associated with vertebral fractures. These findings suggested that BMD testing and TBS measurement have a clinical implication as a screening tool for evaluating the risk of vertebral fractures in thalassemic patients, particularly in β-thalassemia/Hb E who have endocrinopathies.

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