Bone Quality as Measured by Trabecular Bone Score in Normocalcemic Primary Hyperparathyroidism

Area of Science:

• Endocrinology
• Bone Metabolism
• Osteoporosis Research

Background:

• Normocalcemic hyperparathyroidism (NHPT) bone quality is understudied.
• Trabecular bone score (TBS) assesses bone texture, a key determinant of bone strength.
• Vertebral fractures (VFs) are a significant complication of bone disorders.

Purpose of the Study:

• To evaluate the utility of TBS in NHPT.
• To determine TBS accuracy in predicting VFs in NHPT.
• To compare TBS between NHPT, primary hyperparathyroidism (PHPT), and controls.

Main Methods:

• A multicentric cross-sectional study included 47 NHPT, 41 PHPT, and 39 control subjects.
• Trabecular bone score (TBS) was assessed in all participants.
• Lumbar spine Z-score adjusted for TBS (LS Z-score*TBS) was analyzed for VF prediction.

Main Results:

• TBS values and prevalence of low TBS did not significantly differ among NHPT, PHPT, and control groups.
• LS Z-score*TBS did not predict overall VFs in NHPT (accuracy 55.3%).
• LS Z-score*TBS showed higher accuracy (83%) for predicting moderate-to-severe VFs in NHPT.

Conclusions:

• TBS is not reduced in NHPT.
• LS Z-score adjusted for TBS may aid in identifying moderate-to-severe VFs in NHPT.
• Further research is needed to clarify the role of TBS in NHPT bone health.