Bone Mineral Density Compared to Trabecular Bone Score in Primary Hyperparathyroidism

Jones, Alicia; Simons, Koen; Harvey, Susan; Grill, V.

doi:10.3390/jcm11020330

Cited by 10 publications

(4 citation statements)

References 35 publications

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“…In one study of 106 men and women with acromegaly (mean age 56 y), despite lower TBS in vertebral fracture cases (1.18 vs. 1.202, p < 0.05), TBS was not associated with prevalent vertebral fractures in a multivariate model [ 134 ]. In the other nine studies, TBS was associated with prevalent vertebral fractures, independent of BMD [ 131 – 133 , 135 , 137 – 140 ] or enhanced fracture prediction when combined with BMD [ 136 ]. In four of these studies, however, BMD did not differ between fracture and non-fracture cases [ 131 , 133 , 135 , 139 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies examined TBS and hyperparathyroidism or hypoparathyroidism; conditions which are known to lead to alterations to trabecular bone microarchitecture [ 141 , 142 ]. In studies of patients with hyperparathyroidism or hypoparathyroidism, TBS was significantly lower in fracture compared to non-fracture cases [ 132 , 135 , 137 , 139 , 140 ]. In studies that examined the skeletal profiles of fracture cases, the prevalence of degraded TBS (35 to 57%) was greater than densitometric osteopenia or osteoporosis (11 to 21%) [ 137 , 139 ].…”

Section: Resultsmentioning

confidence: 99%

“…In studies of patients with hyperparathyroidism or hypoparathyroidism, TBS was significantly lower in fracture compared to non-fracture cases [ 132 , 135 , 137 , 139 , 140 ]. In studies that examined the skeletal profiles of fracture cases, the prevalence of degraded TBS (35 to 57%) was greater than densitometric osteopenia or osteoporosis (11 to 21%) [ 137 , 139 ]. Similar skeletal profiles indicating a predominance of altered bone microarchitecture were also reported in chronic obstructive pulmonary disease [ 135 ] and thalassemia [ 136 ].…”

Section: Resultsmentioning

confidence: 99%

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Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

et al. 2023

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Purpose Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice. Supplementary Information ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

et al. 2023

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“…Nevertheless, newer studies based on microfinite element models obtained from high-resolution peripheral quantitative computed tomography (HRpQCT) images showed that in PHPT, there is a significant stiffness decrease in cortical and trabecular scores, 16 , 17 along with a decreased trabecular number, volumetric BMD, and connectivity. 18 - 20 …”

Section: Introductionmentioning

confidence: 99%

Degraded Bone Microarchitecture in Women with PHPT–Significant Predictor of Fracture Probability

Oprea

Barbu

Martin

et al. 2023

Clin Med Insights Endocrinol Diabetes

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Introduction: Patients with primary hyperparathyroidism (PHPT) experience bone mineral density (BMD) loss and trabecular bone score (TBS) alteration, which current guidelines recommend assessing. Considering TBS alongside BMD for a 10-year fracture risk assessment (FRAX) may improve PHPT management. Design: Retrospective, cross-sectional study composed of 49 Caucasian females (62 ± 10.6 years, 27.7 ± 0.87 kg/m2) with PHPT and 132 matched control subjects (61.3 ± 10.5 years, 27.5 ± 0.49 kg/m2) evaluated in 3 years. We assessed lumbar spine (LS) and femoral neck (FN) BMD, T and Z scores (GE Healthcare Lunar Osteodensitometer) and TBS (iNsight 1.8), major osteoporotic fracture (MOF), and hip FRAX. Results: Patients with PHPT had statistically lower mean values for lumbar spine bone mineral density (LS BMD) (0.95 ± 0.25 vs 1.01 ± 0.14 g/cm2, P = .01), LS T-scores (−2 ± 0.2 vs −1.4 ± 0.1 SD, P = .009), LS Z scores (−0.9 ± 0.19 vs −0.1 ± 0.11 SD, P = .009), femoral neck bone mineral density (FN BMD) (0.79 ± 0.02 vs 0.83 ± 0.01 g/cm2, P = .02), FN T-scores (−1.8 ± 0.13 vs −1.5 ± 0.07 SD, P = .017), FN Z scores (−0.51 ± 0.87 vs −0.1 ± 0.82 SD, P = .006), and TBS (0.95 ± 0.25 vs 1.01 ± 0.14 g/cm2, P = .01) compared with control subjects. 22.4% of patients with PHPT had degraded microarchitecture (TBS < 1.2) vs. 7.6% in control group (χ2 = 0.008). PHPT proved to be a covariate with unique contribution ( P = .031) alongside LS BMD ( P = .040) in a linear regression model [ R2 = 0.532, F(4,16) = 4.543] for TBS < 1.2. TBS adjustment elevated MOF FRAX both for PHPT (4.35 ± 0.6% vs 5.25% ± 0.73%, P < .001) and control groups (4.5 ± 0.24% vs 4.7% ± 0.26%, P < .001) compared with BMD-bases FRAX, but also increased differently between the 2 study groups (1.1-folds for PHPT patients and 1.04 for control subjects, P = .034). Conclusion: Compared with control, TBS-adjusted FRAX provides significantly higher MOF risk than BMD-based FRAX in PHPT women.

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Bone quality in endocrine diseases: determinants and clinical relevance

Cianferotti

Cipriani

Corbetta

et al. 2023

J Endocrinol Invest

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Bone Mineral Density Compared to Trabecular Bone Score in Primary Hyperparathyroidism

Cited by 10 publications

References 35 publications

Degraded Bone Microarchitecture in Women with PHPT–Significant Predictor of Fracture Probability

Bone quality in endocrine diseases: determinants and clinical relevance

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