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Author Spotlight: An Economic and Efficient Method for Quantitative Evaluation of Bone Microarchitecture in a Murine Osteoporosis Model
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Bone Mineral Density Compared to Trabecular Bone Score in Primary Hyperparathyroidism.

Alicia R Jones1, Koen Simons2,3, Susan Harvey4

  • 1Department of Endocrinology and Diabetes, Western Health, Furlong Road, St Albans, VIC 3021, Australia.

Journal of Clinical Medicine
|January 21, 2022
PubMed
Summary

Primary hyperparathyroidism (PHPT) patients show degraded bone architecture, with Trabecular Bone Score (TBS) better identifying this than bone mineral density (BMD). TBS did not improve after parathyroidectomy in this study.

Keywords:
bone mineral densityfractureshyperparathyroidismosteoporosis

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Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Medical Imaging

Background:

  • Primary hyperparathyroidism (PHPT) is associated with reduced bone mineral density (BMD) at cortical sites and increased fracture risk.
  • Trabecular Bone Score (TBS) may offer a more accurate assessment of bone quality and fracture risk in PHPT patients.

Purpose of the Study:

  • To compare the ability of BMD and TBS to describe bone quality in individuals with PHPT.
  • To evaluate TBS's effectiveness in predicting fractures in PHPT.
  • To assess changes in TBS following parathyroidectomy.

Main Methods:

  • Retrospective cross-sectional study with a longitudinal component.
  • Inclusion of adults with PHPT from a tertiary Australian hospital over ten years.
  • Primary outcome: Lumbar spine TBS compared to BMD for bone quality and fracture prediction.

Main Results:

  • Of 68 participants (mean age 65.3 years, 79% female), 57.4% had TBS indicative of degraded architecture (≤1.20), while only 20.6% had osteoporosis by lumbar spine BMD.
  • A trend towards improved fracture prediction with TBS over BMD was observed but not statistically significant.
  • No significant improvement in TBS was noted in 15 individuals post-parathyroidectomy.

Conclusions:

  • TBS is more sensitive than BMD in detecting degraded bone architecture in PHPT.
  • Current TBS assessment does not appear to improve post-parathyroidectomy.
  • Further research is needed to clarify TBS's role in fracture risk prediction in PHPT.