Trabecular bone score (TBS)--a novel method to evaluate bone microarchitectural texture in patients with primary...

Area of Science:

• Endocrinology
• Bone Metabolism
• Radiology

Background:

• Primary hyperparathyroidism (PHPT) can present with preserved bone mineral density (BMD) on dual-energy x-ray absorptiometry (DXA), masking underlying trabecular microstructural abnormalities.
• High-resolution peripheral quantitative computed tomography (HRpQCT) reveals impaired trabecular microstructure in PHPT, yet its limited availability restricts widespread clinical use.
• Trabecular Bone Score (TBS) offers a novel approach to indirectly assess trabecular microarchitecture using standard DXA images.

Purpose of the Study:

• To evaluate the utility of TBS derived from spine DXA in assessing trabecular microstructure in postmenopausal women with PHPT.
• To correlate TBS with HRpQCT-derived indices and bone stiffness measurements in the radius and tibia.

Main Methods:

• Cross-sectional study involving 22 postmenopausal women diagnosed with PHPT.
• Measurements included areal BMD (DXA), TBS, HRpQCT parameters, and bone stiffness via finite element analysis of the distal radius and tibia.

Main Results:

• TBS was significantly reduced in PHPT patients (1.24), indicating abnormal trabecular microstructure.
• TBS demonstrated correlations with whole bone stiffness and most HRpQCT indices at the tibia, and some indices at the radius.
• Adjusted for body weight, TBS correlated with all trabecular microarchitecture indices except trabecular thickness.

Conclusions:

• TBS, a readily available measurement from DXA, shows potential for evaluating trabecular microstructural integrity in PHPT.
• TBS may serve as a valuable clinical tool for assessing bone quality in PHPT, complementing traditional BMD measurements.