Trabecular bone score and bone mineral density in acromegalic osteopathy assessment: a cross-sectional study

Sorohan, Madalina; Duşceac, Roxana; Sorohan, Bogdan; Caragheorgheopol, Andra; Poiană, Cătălina

doi:10.1007/s11657-021-00986-7

Cited by 8 publications

(16 citation statements)

References 34 publications

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“…In the present study, we found that TBS values were lower in acromegalic patients compared to age, BMI, and sex-matched healthy controls, while no significant differences were observed in BMD values between the two groups, both at lumbar and femoral sites. These data are in line with the results reported by other authors, although some studies did not find significant differences in TBS values between patients and matched controls [ 23 , 41 , 42 , 43 , 45 , 46 , 47 ]. Furthermore, we observed that both BMD and TBS values were significantly lower in hypogonadal patients compared to the eugonadal ones, thus confirming the pivotal role of gonadal status on both bone density and quality in acromegaly [ 6 , 40 ].…”

Section: Discussionsupporting

confidence: 93%

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Trabecular Bone Score as a Reliable Measure of Lumbar Spine Bone Microarchitecture in Acromegalic Patients

Nazzari

Casabella

Paolino

et al. 2022

JCM

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Although GH and IGF-1 excess has a controversial impact on bone mineral density (BMD), acromegalic patients display variable degrees of bone structure impairment. In this study, we aim to investigate the usefulness of trabecular bone score (TBS), compared to BMD, in identifying acromegalic patients with impaired lumbar spine trabecular microarchitecture. Forty-four acromegalic patients were investigated for disease control, metabolic and gonadal status, bone metabolism parameters, and the presence of vertebral fractures (VFs). Patients and matched healthy controls underwent BMD and TBS examination. Mean TBS values were lower in patients than in controls (p < 0.001), without significant differences in mean lumbar and femoral BMD. TBS values were significantly higher in controlled patients compared to the uncontrolled ones (p = 0.012). No significant differences were found in bone markers with respect to disease control. Mean TBS or lumbar BMD did not significantly differ in patients with or without VFs (prevalence 11.4%). TBS and BMD levels were lower in hypogonadal patients compared to the eugonadal ones (p = 0.030 and p < 0.001, respectively). In conclusion, TBS values are significantly lower in patients than in controls, confirming the presence of impaired lumbar spine trabecular bone in acromegaly. Both uncontrolled disease and hypogonadism contribute to TBS deterioration in acromegaly.

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Section: Discussionsupporting

confidence: 93%

“…Currently, few studies have analyzed TBS in patients with acromegaly [ 23 , 24 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. In most cases, the authors reported lower TBS values in acromegalic patients compared to healthy subjects.…”

Section: Introductionmentioning

confidence: 99%

Trabecular Bone Score as a Reliable Measure of Lumbar Spine Bone Microarchitecture in Acromegalic Patients

Nazzari

Casabella

Paolino

et al. 2022

JCM

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“…Though the risk somewhat decreases with biochemical control of the disease, acromegaly patients still continue to have a higher risk of incident VF than healthy controls, due to some degree of irreversible alterations in bone structure [13] BMD in acromegaly has been reported to be unchanged, increased, or decreased and the increased fracture incidence cannot be explained on the basis of BMD alone [4]. TBS, an indirect assessment marker for bone microarchitecture, has been investigated as a potential predictor of increased fracture risk in acromegaly [14][15][16][17][18][19][20][21][22]. A recent meta-analysis evaluated TBS as an index of skeletal fragility in acromegaly [23].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported gonadal status to be an important predictor of bone health in acromegaly, with hypogonadal patients having lower TBS than eugonadal ones [18]. However, a few studies again showed that TBS was independent of gonadal status in acromegaly [19,23]. More importantly, the duration of untreated hypogonadism might play a role in the overall status of bone health in acromegaly.…”

Section: Gonadal Status and Bone Health In Acromegalymentioning

confidence: 99%

Bone mineral density and bone microarchitecture assessment using trabecular bone score in Acromegaly

Boro

Nagendra

Mondal

et al. 2023

Preprint

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Purpose We aimed to analyze the bone mineral density (BMD) and bone microarchitecture using the trabecular bone score (TBS) in acromegaly and compare it with healthy controls. Methods The current study included 50 patients with active acromegaly and 50 age and sex-matched controls. Biochemical parameters were analyzed using standardized techniques. BMD was assessed using dual-energy X-ray absorptiometry (DXA). (Discovery A 84023, Hologic Inc, MA, USA). TBS of the lumbar spine was measured using TBS iNsight software (version 3.0.2.0, medimaps, Merignac, France) installed on the same DXA machine. Results Acromegaly patients had a significantly greater lumbar spine [(1.026 ± 0.180) g/cm2 vs (0.951 ± 0.108) g/cm2, p=0.014], femoral neck [(0.879 ± 0.136) g/cm2 vs (0.780 ± 0.110) g/cm2, p<0.001], and total hip BMD [(1.013 ± 0.128) g/cm2 vs (0.917 ± 0.118) g/cm2, p<0.001] than healthy controls while no significant difference was observed in the distal radius BMD [(0.700 ± 0.102) g/cm2 vs (0.698 ± 0.087) g/cm2, p=0.890] and TBS [(1.348 ± 0.086) vs (1.345 ± 0.091), p=0.890]. No significant difference was observed in the TBS between eugonadal and hypogonadal acromegaly cases, be they male or female. On multiple linear regression analysis, ‘age’ and ‘lumbar spine BMD’ were found to predict TBS in acromegaly. Conclusion Our study showed no difference in TBS between acromegaly and controls, irrespective of gender and gonadal status. Further studies (longitudinal) with the involvement of a large sample size are required to analyze the utility of TBS in the prediction of skeletal health and fracture risk in acromegaly.

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“…In general, compared to control subjects, TBS was reported to be lower in patients with diabetes (42,(57)(58)(59), primary hyperparathyroidism (60)(61)(62)(63)(64), acromegaly (65)(66)(67)(68), anorexia nervosa (69,70), hypercortisolism (71)(72)(73), primary aldosteronism (especially in women) (74), with prolonged GC exposure (75)(76)(77)(78)(79)(80)(81)(82)(83)(84), rheumatoid arthritis and rheumatic disease (85)(86)(87), aromatase inhibition (88), kidney transplant recipients (89), as well as in patients on hemodialysis (90,91). In differentiated thyroid carcinomas, TBS was found to be lower in patients receiving long-term suppressive doses of thyroid-stimulating hormone than in patients receiving shorter-term therapy (92)(93)(94).…”

Section: Tbs and Fracture Risk Prediction In Patients With Diabetes A...mentioning

confidence: 92%

Update on trabecular bone score

Palomo¹,

Muszkat²,

Weiler³

et al. 2022

Archives of Endocrinology and Metabolism

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Trabecular bone score (TBS) is an indirect and noninvasive measure of bone quality. A low TBS indicates degraded bone microarchitecture, predicts osteoporotic fracture, and is partially independent of clinical risk factors and bone mineral density (BMD). There is substantial evidence supporting the use of TBS to assess vertebral, hip, and major osteoporotic fracture risk in postmenopausal women, as well as to assess hip and major osteoporotic fracture risk in men aged > 50 years. TBS complements BMD information and can be used to adjust the FRAX (Fracture Risk Assessment) score to improve risk stratification. While TBS should not be used to monitor antiresorptive therapy, it may be potentially useful for monitoring anabolic therapy. There is also a growing body of evidence indicating that TBS is particularly useful as an adjunct to BMD for fracture risk assessment in conditions associated with increased fracture risk, such as type-2 diabetes, chronic corticosteroid excess, and other conditions wherein BMD readings are often misleading. The interference of abdominal soft tissue thickness (STT) on TBS should also be considered when interpreting these findings because image noise can impact TBS evaluation. A new TBS software version based on an algorithm that accounts for STT rather than BMI seems to correct this technical limitation and is under development. In this paper, we review the current state of TBS, its technical aspects, and its evolving role in the assessment and management of several clinical conditions.

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Trabecular bone score and bone mineral density in acromegalic osteopathy assessment: a cross-sectional study

Cited by 8 publications

References 34 publications

Trabecular Bone Score as a Reliable Measure of Lumbar Spine Bone Microarchitecture in Acromegalic Patients

Trabecular Bone Score as a Reliable Measure of Lumbar Spine Bone Microarchitecture in Acromegalic Patients

Bone mineral density and bone microarchitecture assessment using trabecular bone score in Acromegaly

Update on trabecular bone score

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