Bone microstructure of adult patients with non-surgical hypoparathyroidism assessed by high-resolution peripheral quantitative computed tomography

Liu, J.; Chen, S.; Quan, T.; Wang, Y.; Wang, O.; Nie, M.; Jiang, Y.; Li, M.; Xing, X.; Xia, W.

Affiliations

¹Department of Endocrinology, Key Laboratory of Endocrinology of the Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China

²Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China

³Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China

Abstract and keywords

Summary: There is limited evidence regarding changes in bone microstructure in patients with hypoparathyroidism. In the current study, we used a non-invasive technique to assess bone structure in hypoparathyroidism patients and discovered site-specific changes which were mainly influenced by age and menstrual status. Such changes were more prominent in the trabeculae as well as in non-surgical as opposed to post-surgical patients.

Introduction: Hypoparathyroidism (hypoPT) is a rare disease characterized by the lack of parathyroid hormone. There is limited evidence regarding changes in bone microstructure in patients with non-surgical hypoPT. We investigated bone microstructure of patients with non-surgical hypoPT using a non-invasive technique.

Methods: Patients with hypoPT were assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT) and compared to age- and sex-matched healthy controls randomly selected from a pre-existing HR-pQCT database in a cross-sectional study. Preliminary comparison between patients with different etiologies of hypoPT was performed. Associations between bone microstructure and clinical parameters were investigated using correlation and regression analyses.

Results: A total of 94 patients with non-surgical hypoPT were recruited. Patients displayed an increase in trabecular volumetric BMD of the tibia (170.57 ± 34.32 vs. 156.48 ± 40.55 mg HA/cm3, p = 0.011) and increase in trabecular number of both the radius (1.48 ± 0.29 vs. 1.36 ± 0.22 mm−1, p = 0.003) and tibia (1.42 ± 0.23 vs. 1.24 ± 0.22 mm−1, p < 0.001) compared to healthy controls. Trabecular number was higher for non-surgical hypoPT compared to post-surgical hypoPT (1.37 ± 0.25 and 1.17 ± 0.13 mm−1, p = 0.022). Trends towards increase in cortical volumetric BMD were only present for post-menopausal female and male patients above the age of 50. For female patients, cortical volumetric BMD and area increased with age and decreased after menopause. For males, age had little influence on bone microstructure, but cortical porosity increased with longer treatment durations.

Conclusions: Results from this pilot study suggested that both cortical and trabecular bone were altered in this group of patients with hypoPT. Etiology for hypoPT might influence bone microstructure, mainly on trabeculae. Age, menstrual status, and treatment duration were likely to influence bone microstructure in hypoPT.

Keywords: Bone microstructure; HR-pQCT; Non-surgical hypoparathyroidism

Links

DOI: 10.1007/s00198-020-05506-w

PubMed: 32623488

WoS: 000545298900001

History

Received: 2020-04-02

Accepted: 2020-06-15

Online: 2020-07-04

Cited Works (10)

Year	Entry
2006	Khosla S, Riggs BL, Atkinson EJ, Oberg AL, McDaniel LJ, Holets M, .Peterson JM, Melton LJ III. Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. J Bone Miner Res. January 2006;21(1):124-131.
2005	Boutroy S, Bouxsein ML, Munoz F, Delmas PD. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab. December 2005;90(12):6508-6515.
2010	Rubin MR, Dempster DW, Kohler T, Stauber M, Zhou H, Shane E, Nickolas T, Stein E, Sliney J Jr, Silverberg SJ, Bilezikian JP, Müller R. Three dimensional cancellous bone structure in hypoparathyroidism. Bone. January 2010;46(1):190-195.
2015	Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L. The epidemiology of nonsurgical hypoparathyroidism in Denmark: a nationwide case finding study. J Orthop Res. September 2015;30(9):1738-1744.
1998	Laib A, Häuselmann HJ, Rüegsegger P. In vivo high resolution 3D-QCT of the human forearm. Technol Health Care. 1998;6(5-6):329-337.
1993	McCalden RW, McGeough JA, Barker MB, Court-Brown CM. Age-related changes in the tensile properties of cortical bone: the relative importance of changes in porosity, mineralization, and microstructure. J Bone Joint Surg. 1993;75A(8):1193-1205.
2002	Turner CH. Biomechanics of bone: determinants of skeletal fragility and bone quality. Osteoporos Int. February 2002;13(2):97-104.
2010	Nishiyama KK, Macdonald HM, Buie HR, Hanley DA, Boyd SK. Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. J Bone Miner Res. April 2010;25(4):882-890.
2011	Macdonald HM, Nishiyama KK, Kang J, Hanley DA, Boyd SK. Age‐related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: a population‐based HT‐pQCT study. J Bone Miner Res. January 2011;26(1):50-62.
2009	Holzer G, von Skrbensky G, Holzer LA, Pichl W. Hip fractures and the contribution of cortical versustrabecular bone to femoral neck strength. J Bone Miner Res. March 2009;24(3):468-474.