Trabecular Bone Score in Obese and Non-obese Subjects with Primary Hyperparathyroidism Before and After Parathyroidectomy.

Trabecular Bone Score in Obese and Non-obese Subjects with Primary Hyperparathyroidism Before and After Parathyroidectomy.

J Clin Endocrinol Metab. 2018 Jan 24;:

Authors: Donovan Tay YK, Cusano NE, Rubin MR, Williams J, Omeragic B, Bilezikian JP

Abstract
Context: Obesity has been shown to be unfavorable to skeletal microarchitecture when assessed by trabecular bone score (TBS). The influence of adiposity on skeletal microstructure in primary hyperparathyroidism (PHPT) has not yet been evaluated.
Objective: To investigate the effect of obesity on TBS and bone mineral density (BMD) in subjects with PHPT at baseline and through 2 years after parathyroidectomy.
Design: Prospective observational study.
Setting: Referral center.
Patients or Other Participants: 30 men and women with PHPT undergoing parathyroid surgery.
Main Outcome Measures: TBS and BMD by dual-energy X-ray absorptiometry.
Results: There were significant improvements in lumbar spine and femoral neck BMD in the obese (lumbar spine: +4.3 ± 4.7%, femoral neck: +3.8 ± 6.6%; p<0.05 for both) and non-obese subjects (lumbar spine: +3.8 ± 5.6, femoral neck +3.1 ± 5.0%; p<0.05 for both) but no significant change in TBS in either group at 24 months post-parathyroidectomy. Obese subjects had fully degraded TBS values compared to the non-obese subjects, whose TBS values were minimally below normal throughout the study (Baseline: 1.199 ± 0.086 vs 1.327 ± 0.099, respectively; p=0.003; 24 months: 1.181 ± 0.061 vs 1.352 ± 0.114, respectively; p=0.001), despite improvements in BMD.
Conclusions: The detrimental effect of obesity on TBS, an index of bone quality, was demonstrated in subjects with PHPT. Obesity was associated with fully degraded skeletal microarchitecture as measured by TBS in PHPT, despite similar values in bone density by DXA compared to non-obese subjects. TBS values did not improve post-parathyroidectomy in either obese or non-obese subjects.

PMID: 29373705 [PubMed - as supplied by publisher]

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