Trabecular bone score (TBS) evaluates bone microarchitecture by measuring the grey-level variations from lumbar spine dual-energy X-ray absorbtiometry (DXA) images. Bone mineral density (BMD) in various endocrinopathies might not be sufficient in assessing bone fragility, especially in patients with acromegaly (ACM) but also in thyrotoxicosis. The aim of our study was to evaluate bone quality and quantity by BMD and TBS in patients with acromegaly and thyrotoxicosis.
Methods: We performed an observational, case-control study on 42 patients with acromegaly and thyrotoxicosis. Inclusion criteria were adult patients, with a positive diagnosis of acromegaly or thyrotoxicosis, with an active or residual disease, who performed DXA in our clinic. One analysis included 20 patients with acromegaly and 20 healthy controls mached 1:1 by age and gender. The second analysis was performed on 22 patients with thyrotoxicosis matched 1:1 with 22 healthy subjects, also according to age and gender. Anthropometric, biological, lumbar spine BMD, femoral neck BMD and lumber spine TBS were measured.
Results: When we compared TBS and BMD between patients with acromegaly and controls we found a non-statistically significant lower lumbar spine TBS (1.308±0.140 vs 1.331±0.118, P=0.58), femoral neck BMD (0.997±0.152 vs 1.069±0.319, P=0.36) and a higher lumber spine BMD (1.195±0.170 vs 1.128±0.203, P=0.25) in patients with acromegaly. In the second analysis, we found a lower but not statistically significant femoral neck BMD (0.774±0.419 vs 0.858±0.135, P=0.37) in the thyrotoxicosis group. Also, mean lumbar spine BMD and lumbar spine TBS did not show any difference between thyrotoxicosis and control group (0.997±0.187 vs 0.999±0.173, P=0.97 and 1.266±0.164 vs 1.269±0.124, P=0.94, respectively). In conclusion, in our study, TBS did not show superior results in evaluating bone quality alterations compared to BMD in patients with acromegaly and thyrotoxicosis.
18 - 21 May 2019
European Society of Endocrinology