TRABECULAR BONE SCORE IN PATIENTS WITH NORMOCALCEMIC HYPERPARATHYROIDISM.

Area of Science:

• Endocrinology
• Bone Metabolism
• Radiology

Background:

• Hyperparathyroidism (HPT) impacts bone, but effects of normocalcemic (NHPT) versus hypercalcemic (HHPT) forms are unclear.
• Trabecular Bone Score (TBS) assesses bone microarchitecture, complementing areal bone mineral density (aBMD).
• Understanding TBS differences in HPT subtypes is crucial for bone health assessment.

Purpose of the Study:

• To compare the Trabecular Bone Score (TBS) in patients with normocalcemic hyperparathyroidism (NHPT) and asymptomatic hypercalcemic hyperparathyroidism (HHPT).
• To evaluate the relationship between parathyroid hormone (PTH) levels and bone health parameters in asymptomatic HPT.
• To determine if NHPT and HHPT have distinct effects on bone microarchitecture.

Main Methods:

• Prospective study of asymptomatic HPT patients (NHPT and HHPT) and controls with ≥1 year follow-up.
• Evaluation of metabolic phosphocalcium parameters, TBS, and areal bone mineral density (aBMD).
• Statistical analysis to compare groups and assess correlations between TBS, PTH, and other factors.

Main Results:

• No significant difference in TBS or aBMD between NHPT and HHPT patients.
• Asymptomatic HPT patients exhibited significantly higher PTH and calcium levels compared to controls.
• A significant negative correlation was found between TBS and PTH in asymptomatic HPT patients, independent of age, sex, and BMI.

Conclusions:

• TBS does not differ between NHPT and HHPT patients.
• Asymptomatic HPT is associated with reduced TBS, linked to elevated PTH levels.
• The observed alteration in bone microarchitecture texture by PTH does not impact overall bone mass.