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Endocrine Abstracts (2021) 73 AEP104 | DOI: 10.1530/endoabs.73.AEP104


1Campus Bio-Medico, Unit of endocrinology and Diabetes, Rome, Italy; 2IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; 3TECHNOLOGIC Srl, Turin, Italy; 4UOS Malattie Metaboliche, Santa Maria Goretti Hospital, latina, Italy; 5Unit of Endocrinology and Metabolic Diseases, CTO A. Alesini Hospital, University Tor Vergata, Rome, Italy; 6College of Physicians & Surgeons, Columbia University, Department of Medicine, Division of Endocrinology, new york, United States; 7Casa di Cura La Madonnina, Milan, Italy


Primary hyperparathyroidism (PHPT) is associated with impaired bone quality and increased fracture risk. Reliable tools for the evaluation of bone quality parameters are not yet clinically available. Bone Strain Index (BSI) is a new metric for bone strength based on Finite Element Analysis from lumbar spine and femoral neck dual X-ray absorptiometry images.


To assess the lumbar spine (LS), femoral neck (FN), and total hip (TH) BSI in PHPT compared to controls.


Cross-sectional study. Outpatient clinic


44 PHPT and 39 age- and sex-matched control subjects.

Main outcome measures



TH bone mineral density (BMD) and 1/3 distal radius BMD were lower in the PHPT group than in controls (TH 0.802 ± 0.13 vs 0.872 ± 0.09, P < 0.05; radius 0.565 ± 0.07 vs 0.620 ± 0.06, P < 0.001). There were no differences between groups in trabecular bone score (TBS) and T-score adjusted for TBS. BSI was significantly higher at LS (2.20 ± 0.58 vs 1.94 ± 0.48, P = 0.003), FN (1.66 ± 0.39 vs 1.40 ± 0.36, P = 0.003) and TH (1.46 ± 0.3 vs 1.24 ± 0.25, P = 0.001) in PHPT. LS-BSI showed moderate accuracy for detecting vertebral fractures [(area under the ROC curve 0.68 (CI:0.52–0.848)]. The best cut-off was set at 2.12 (sensibility 72%, specificity 64%, accuracy 67.4%).


BSI, a DXA-derived bone quality index, is impaired in PHPT and may help to identify PHPT subjects at high risk of fractures.

Volume 73

European Congress of Endocrinology 2021

22 May 2021 - 26 May 2021

European Society of Endocrinology 

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