Associations between trabecular bone score and biochemistry in surgically vs conservatively treated outpatients with primary hyperparathyroidism: A retrospective cohort study

Leere, Julius Simoni; Kruse, Christian; Robaczyk, Maciej; Karmisholt, Jesper; Vestergaard, Peter

doi:10.1016/j.bonr.2018.08.001

Cited by 16 publications

(8 citation statements)

References 50 publications

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“…The correlation between TBS and BMD is not consistent in different populations [21,22,23] . The difference could be related to the difference of the race.…”

Section: Discussionmentioning

confidence: 85%

Usefulness of Trabecular Bone Score (TBS) to Identify Bone Quality and Bone Fragility in Primary Hyperparathyroidism compared with Secondary Hyperparathyroidism——hypercortisolism patients

Tang

Jia

Wang

et al. 2022

Preprint

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Purpose: This study was designed to evaluates the effects of TBS, bone mineral density (BMD), and fracture risk in PHPT patients.Methods: The study group comprised 82 PHPT patients, and sex-, age-matched 50 hypercortisolism patients. The BMD and TBS were measured using DXA and TBS iNsight software. A receiver operating curve and logistic analysis were used to evaluate TBS. The FRAX index was calculated with and without the adjustment of TBS to evaluate the sensitivity and specificity of fracture risk. Results: Sixty-two per cent of PHPT patients exhibited degraded bone microstructure, thirty-nine per cent were diagnosed with osteoporosis by DXA. TBS had a moderately positive correlation with the lumbar spine, femoral neck, and total hip BMD. For PHPT patients, the BMD of the fracture group was lower compared to that of the non-fracture group, and the FRAX indexes were higher than that of the non-fracture group. There was no statistical difference in TBS between the fracture group and the non-fracture group. In hypercortisolism patients, there was no statistical difference in BMD and TBS between the fracture group and the non-fracture group. In PHPT patients, TBS was a predictor of osteoporosis even after adjusting for age, gender, and BMI (P = 0.001, OR = 0.120, 95% CI [0.033-0.435]); In contrast, TBS was not a predictor in hypercortisolism patients, regardless of whether adjusting confounding factors or not. The sensitivity of FRAX in the prediction of fracture risk in PHPT and hypercortisolism is higher than TBS alone. Conclusions: TBS combined with BMD can increase the diagnostic accuracy of PHPT patients. Moreover, FRAX is more sensitive to fracture prediction than TBS in patients with PHPT or hypercortisolism.

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“…The correlation between TBS and BMD is not consistent in different populations [21,22,23] . The difference could be related to the difference of the race.…”

Section: Discussionmentioning

confidence: 85%

Usefulness of Trabecular Bone Score (TBS) to Identify Bone Quality and Bone Fragility in Primary Hyperparathyroidism compared with Secondary Hyperparathyroidism——hypercortisolism patients

Tang

Jia

Wang

et al. 2022

Preprint

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“…Several studies evaluated TBS in PHPT. (74)(75)(76)(77)(78)(79)(80)(81)(82) TBS was significantly lower in patients than in controls, (75,76,82) or it was degraded despite a well-preserved LS BMD by DXA. (74,76,78,81) By HRpQCT, patients with mild PHPT have decreased volumetric BMDs (vBMD; total, cortical, and trabecular), cortical thickness, and trabecular number, and more widely spaced and heterogeneously distributed trabeculae, compared to controls (83)(84)(85)(86) (Fig.…”

Section: Trabecular Bone Score Qct and Microindentationmentioning

confidence: 83%

“…Several studies evaluated TBS in PHPT. ( 74‐82 ) TBS was significantly lower in patients than in controls, ( 75,76,82 ) or it was degraded despite a well‐preserved LS BMD by DXA. ( 74,76,78,81 )…”

Section: Introductionmentioning

confidence: 99%

Classical and Nonclassical Manifestations of Primary Hyperparathyroidism

Fuleihan

Chakhtoura

Cipriani

et al. 2020

Journal of Bone and Mineral Research

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This narrative review summarizes data on classical and nonclassical manifestations of primary hyperparathyroidism (PHPT). It is based on a rigorous literature search, inclusive of a Medline search for systematic reviews from 1940 to December 2020, coupled with a targeted search for original publications, covering four databases, from January 2013-December 2020, and relevant articles from authors' libraries. We present the most recent information, identify knowledge gaps, and suggest a research agenda. The shift in the presentation of PHPT from a predominantly symptomatic to an asymptomatic disease, with its varied manifestations, has presented several challenges. Subclinical nephrolithiasis and vertebral fractures are common in patients with asymptomatic disease. The natural history of asymptomatic PHPT with no end organ damage at diagnosis is unclear. Some observational and cross-sectional studies continue to show associations between PHPT and cardiovascular and neuropsychological abnormalities, among the different disease phenotypes. Their causal relationship is uncertain. Limited new data are available on the natural history of skeletal, renal, cardiovascular, neuropsychological, and neuromuscular manifestations and quality of life. Normocalcemic PHPT (NPHPT) is often diagnosed without the fulfillment of rigorous criteria. Randomized clinical trials have not demonstrated a consistent long-term benefit of parathyroidectomy (PTX) versus observation on nonclassical manifestations. We propose further refining the definition of asymptomatic disease, into two phenotypes: one without and one with evidence of target organ involvement, upon the standard evaluation detailed in our recommendations. Each of these phenotypes can present with or without non-classical manifestations. We propose multiple albumin-adjusted serum calcium determinations (albumin-adjusted and ionized) and exclusion of all secondary causes of high parathyroid hormone (PTH) when establishing the diagnosis of NPHPT. Refining the definition of asymptomatic disease into the phenotypes proposed will afford insights into their natural history and response to interventions. This would also pave the

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“…Since TBS derives from LS BMD assessment, this could be a possible explanation. However, data from the literature are conflicting, with some authors describing a negative relationship between the two parameters [40,41]. Depending on DXA manufacture, BMI negatively correlated with TBS in Hologic measurement, but not in GE lunar [42], this difference being a result of the manner in which the software attenuates abdominal tissue mass.…”

Section: Discussionmentioning

confidence: 97%

Body Composition as a Modulator of Bone Health Changes in Patients with Inflammatory Bowel Disease

Soare

Sîrbu

Popa

et al. 2022

Life

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Background: Bone impairment of multifactorial etiology is a common feature in inflammatory bowel disease (IBD). Body composition parameters, which might be selectively modified in these patients, are important determinants of bone strength. Our aim was to investigate the relationship between components of body composition and bone parameters in IBD patients. Methods: This is a cross-sectional, retrospective study including 80 IBD patients (43 women, 37 men). Lumbar spine (LS), femoral neck (FN) and whole body DXA scans were performed to analyze regional bone mineral density (BMD), as well as body composition, including appendicular skeletal muscle mass index (ASMI), total and visceral fat mass (VAT). Trabecular bone score (TBS) was assessed using iNsight Software. Results: Twenty (25%) IBD patients had inadequate LS-BMD z scores (<=−2DS). Lean mass (LM) was a significant determinant of LS-BMD, after adjusting for age, gender, BMI and fat mass (p < 0.01), while fat mass% remained associated with FN-BMD (p < 0.01). TBS correlated positively with BMI (r = 0.24, p < 0.05), LS-BMD (r = 0.56, p < 0.001), ASMI (r = 0.34, p < 0.001) and negatively with VAT/total fat% (r = −0.27, p < 0.05). Multivariate analysis showed that ASMI, LS-BMD (positively) and VAT/total fat% (negatively) were independently associated with TBS. Conclusions: In IBD patients, skeletal muscle mass and fat percentage and distribution are important factors associated with bone health.

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Associations between trabecular bone score and biochemistry in surgically vs conservatively treated outpatients with primary hyperparathyroidism: A retrospective cohort study

Cited by 16 publications

References 50 publications

Usefulness of Trabecular Bone Score (TBS) to Identify Bone Quality and Bone Fragility in Primary Hyperparathyroidism compared with Secondary Hyperparathyroidism——hypercortisolism patients

Usefulness of Trabecular Bone Score (TBS) to Identify Bone Quality and Bone Fragility in Primary Hyperparathyroidism compared with Secondary Hyperparathyroidism——hypercortisolism patients

Classical and Nonclassical Manifestations of Primary Hyperparathyroidism

Body Composition as a Modulator of Bone Health Changes in Patients with Inflammatory Bowel Disease

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