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DXA-based bone strain index in normocalcemic primary hyperparathyroidism.

Gaia Tabacco1,2, Anda Mihaela Naciu3,4, Carmelo Messina5,6

  • 1Unit of Metabolic Bone and Thyroid Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy. g.tabacco@policlinicocampus.it.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
|January 14, 2023
PubMed
Summary

Normocalcemic hyperparathyroidism (NHPT) does not significantly impact bone health as assessed by the bone strain index (BSI). Trabecular and cortical bone in NHPT patients show no significant impairment compared to controls.

Keywords:
Bone qualityBone strain indexNHPTNormocalcemic primary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Radiology

Background:

  • The natural history and bone involvement in normocalcemic hyperparathyroidism (NHPT) require further clarification.
  • The bone strain index (BSI), a finite element-based deformation index applicable to DXA scans, offers a novel method for bone assessment.

Purpose of the Study:

  • To evaluate the bone strain index (BSI) in individuals with normocalcemic hyperparathyroidism (NHPT).
  • To compare BSI values between NHPT, primary hypercalcemic hyperparathyroidism (PHPT), and healthy controls.

Main Methods:

  • A case-control study involving 170 participants: 40 with NHPT, 50 with PHPT, and 80 controls.
  • Age- and sex-matching were employed between the NHPT group and controls.
  • Bone mineral density (BMD) at the lumbar spine, femoral neck, and total hip, along with TBS and BSI, were assessed.

Main Results:

  • No significant differences in lumbar spine (LS), femoral neck (FN), or total hip (TH) bone mineral density (BMD) or TBS were observed between NHPT, PHPT, and controls.
  • Femoral neck-BSI was lower in NHPT compared to PHPT (p=0.031) but not different from controls.
  • Total hip-BSI was lower in NHPT compared to PHPT (p=0.030) but not different from controls. LS-BSI showed no differences across groups.

Conclusions:

  • Trabecular and cortical bone, as evaluated by BSI, do not appear to be significantly impaired in NHPT.
  • Further prospective research is recommended to validate these findings and enhance understanding and management of NHPT.