Trabecular Bone Score (TBS) in Primary Hyperparathyroidism (PHPT): A Useful Tool?

Area of Science:

• Endocrinology
• Bone Metabolism
• Radiology

Background:

• Primary Hyperparathyroidism (PHPT) is frequently associated with bone loss, impacting bone health even in asymptomatic cases.
• Assessing bone fragility risk in PHPT patients is crucial for timely intervention and prevention of fractures.

Purpose of the Study:

• To evaluate the efficacy of Trabecular Bone Score (TBS) in conjunction with Dual X-ray Absorptiometry (DXA) for enhanced bone fragility risk assessment in PHPT patients.
• To determine if TBS can identify PHPT patients at a higher risk of vertebral fractures compared to DXA alone.

Main Methods:

• Sixty-four PHPT patients and sixty-three controls underwent Bone Mineral Density (BMD) measurements using DXA and TBS assessment.
• Vertebral fracture assessment (VFA) was performed using DXA and the Genant method.
• Receiver Operating Characteristic (ROC) curve analysis was used to compare the diagnostic performance of TBS and DXA for vertebral fractures.

Main Results:

• PHPT patients exhibited significantly lower BMD and TBS values compared to controls.
• Osteoporosis prevalence was higher in PHPT patients (50%) than in controls (26.6%).
• TBS demonstrated a higher area under the curve (AUC) than DXA for vertebral fracture assessment in PHPT patients, with TBS values < 1.187 indicating significantly higher fracture risk.

Conclusions:

• Trabecular Bone Score (TBS) is a valuable tool for assessing bone fragility in PHPT patients.
• Combining TBS with DXA measurements offers a more accurate assessment of fracture risk compared to DXA alone.
• TBS can help identify PHPT patients with an elevated risk of vertebral fractures, guiding clinical management.