Trabecular Bone Score as a More Sensitive Tool to Evaluate Bone Involvement in MEN1-related Primary...

Area of Science:

• Endocrinology
• Bone Metabolism
• Radiology

Background:

• Skeletal involvement in primary hyperparathyroidism differs between multiple endocrine neoplasia type 1-related (MHPT) and sporadic (SHPT) forms.
• Trabecular bone score (TBS) is a texture parameter reflecting trabecular bone damage.

Purpose of the Study:

• To compare clinical characteristics and skeletal involvement between MHPT and SHPT patients.
• To evaluate the utility of TBS in assessing bone health in MHPT.

Main Methods:

• Retrospective analysis of 120 MHPT patients and 360 SHPT patients.
• Dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD) and TBS calculation from lumbar spine images.

Main Results:

• MHPT patients were younger at hospital visit despite longer disease duration.
• Skeletal involvement was less frequent in MHPT overall, but similar when matched for age and gender.
• MHPT patients had lower lumbar spine BMD and TBS compared to SHPT patients.
• TBS identified bone microstructure damage in 15 of 34 MHPT patients with normal BMD.

Conclusions:

• Cancellous bone microarchitecture is more severely damaged in MHPT patients as indicated by TBS.
• TBS is a sensitive supplemental index to BMD for identifying bone involvement risk in MHPT.