scholarly journals Bone Mineral Density Compared to Trabecular Bone Score in Primary Hyperparathyroidism

2022 ◽  
Vol 11 (2) ◽  
pp. 330
Author(s):  
Alicia R. Jones ◽  
Koen Simons ◽  
Susan Harvey ◽  
Vivian Grill
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Primary Hyperparathyroidism ◽  
Fracture Risk ◽  
Trabecular Bone ◽  
Bone Quality ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Statistical Significance ◽  
Mineral Density

Individuals with primary hyperparathyroidism (PHPT) have reduced bone mineral density (BMD) according to dual X-ray absorptiometry at cortical sites, with relative sparing of trabecular BMD. However, fracture risk is increased at all sites. Trabecular bone score (TBS) may more accurately describe their bone quality and fracture risk. This study compared how BMD and TBS describe bone quality in PHPT. We conducted a retrospective cross-sectional study with a longitudinal component, of adults with PHPT, admitted to a tertiary hospital in Australia over ten years. The primary outcome was the TBS at the lumbar spine, compared to BMD, to describe bone quality and predict fractures. Secondary outcomes compared changes in TBS after parathyroidectomy. Of 68 included individuals, the mean age was 65.3 years, and 79% were female. Mean ± SD T-scores were −1.51 ± 1.63 at lumbar spine and mean TBS was 1.19 ± 0.12. Only 20.6% of individuals had lumbar spine BMD indicative of osteoporosis, while 57.4% of TBS were ≤1.20, indicating degraded architecture. There was a trend towards improved fracture prediction using TBS compared to BMD which did not reach statistical significance. Comparison of 15 individuals following parathyroidectomy showed no improvement in TBS.

DOES BASELINE PTH INFLUENCE RECOVERY OF BONE MINERAL DENSITY, TRABECULAR BONE SCORE AND BONE TURNOVER MARKERS? A PROSPECTIVE STUDY FOLLOWING CURATIVE PARATHYROIDECTOMY IN PRIMARY HYPERPARATHYROIDISM

2020 ◽  
Vol 26 (12) ◽  
pp. 1442-1450
Author(s):  
Shrinath Shetty ◽  
Kripa Elizabeth Cherian ◽  
Sahana Shetty ◽  
Nitin Kapoor ◽  
Felix K. Jebasingh ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Primary Hyperparathyroidism ◽  
Bone Turnover ◽  
Prospective Study ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Trabecular Bone Score ◽  
Mineral Density ◽  
Turnover Markers

Objective: This prospective study was carried out to assess trabecular bone score, bone mineral density (BMD), and bone biochemistry in Indian subjects with symptomatic primary hyperparathyroidism (PHPT), and to study the influence of baseline parathyroid hormone (PTH) on recovery of these parameters following curative surgery. Methods: This was a 2-year prospective study conducted at a tertiary care centre in southern India. Baseline assessment included demographic details, mode of presentation, bone mineral biochemistry, BMD, trabecular bone score (TBS), and bone turnover markers (BTMs). These parameters were reassessed at the end of the first and second years following curative parathyroid surgery. Results: Fifty-one subjects (32 men and 19 women) with PHPT who had undergone curative parathyroidectomy were included in this study. The mean (SD) age was 44.6 (13.7) years. The TBS, BTMs, and BMD at lumbar spine and forearm were significantly worse at baseline in subjects with higher baseline PTH (≥250 pg/mL) when compared to the group with lower baseline PTH (<250 pg/mL). At the end of 2 years, the difference between high versus low PTH groups (mean ± SD) persisted only for forearm BMD (0.638 ± 0.093 versus 0.698 ± 0.041 g/cm2; P = .01). However, on follow-up visits in the first and second year after curative parathyroidectomy, there was no significant difference in BTMs, BMD at the femoral neck, lumbar spine, and TBS between the 2 groups stratified by baseline PTH. Conclusion: The BMD at the forearm remained significantly worse in individuals with high baseline PTH even at 2 years after surgery, while other parameters including TBS improved significantly from baseline. Abbreviations: 25(OH)D = 25-hydroxyvitamin D; BMD = bone mineral density; BMI = body mass index; BTMs = Bone turnover markers; CTX = C-terminal telopeptide of type 1 collagen; DXA = dual energy X-ray absorptiometry; P1NP = N-terminal propeptide of type 1 procollagen; PHPT = primary hyperparathyroidism; PTH = parathyroid hormone; TBS = trabecular bone score

scholarly journals Trabecular Bone Score, Bone Mineral Density and Bone Markers in Patients with Primary Hyperparathyroidism 2 Years After Parathyroidectomy

2019 ◽  
Vol 51 (03) ◽  
pp. 186-190 ◽  
Author(s):  
Gonzalo Miguel ◽  
Federico Carranza ◽  
Juan Rodríguez ◽  
Mercedes Ramos ◽  
David Pablos ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Primary Hyperparathyroidism ◽  
Bone Turnover ◽  
Trabecular Bone ◽  
Bone Turnover Markers ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Mineral Density ◽  
Turnover Markers

AbstractFollowing a parathyroidectomy there is a bone mineral density (BMD) improvement in patients with primary hyperparathyroidism. However, data of bone microarchitecture are scarce. Trabecular bone score (TBS) estimates bone microarchitecture and could provide valuable information in those patients. The aim of this study is to assess TBS changes 2 years after successful surgery in a group of patients with primary hyperparathyroidism and correlate these results with changes in BMD and bone turnover markers. This is a prospective study including 32 patients. In all participants BMD and TBS were measured, before and 24 months after surgery. Biochemical data: serum calcium, PTH, 25-OH-vitamin D, beta-crosslaps, bone alkaline phosphatase, and osteocalcin. 25 female and 7 male patients, mean age 64.6±12.4 years, were included in the study. At baseline, BMD was low at: lumbar spine (T-score −2.19±1.31), total hip (−1.33±1.12), femoral neck (−1.75±0.84), and distal one-third radius (−2.74±1.68). Baseline TBS showed partially degraded microarchitecture (1.180±0.130). After parathyroidectomy lumbar spine BMD increased significantly (5.3±13.0%, p<0.05), as well as total hip (3.8±8.8%, p<0.05). There was an increase in TBS, but this was not significant. There was a correlation between TBS and BAP at baseline (rs=0.73; p<0.01) and TBS and BAP 2 years after surgery (rs=0.57, p<0.05). Although bone density improves 2 years after surgery in patients with primary hyperparathyroidism and there is a restoration of bone turnover markers, TBS is not completely restored. These results remark the necessity of longer periods of study, to confirm if bone microarchitecture could be completely restored after surgery.

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