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Sakane, Eliane Naomi; Camargo Vieira, Maria Carolina; Lazaretti-Castro, Marise; Maeda, Sergio Setsuo

2019

CONTEXT: The effects of parathyroid hormone deprivation on bone are still unclear. Our objective was to report the characteristics of patients with postsurgical hypoparathyroidism (PsH) at a specialized outpatient service and correlate their trabecular bone score (TBS) values to clinical, densitometric, and laboratory findings. A secondary objective was to evaluate the fracture rates and look for associations between these events and the collected data. RESULTS: Eighty-two patients were enrolled, of whom 70 (85.4%) were female and 17 (20.7%) had type 2 diabetes mellitus (T2DM). The median body mass index (BMI) was 27.7 kg/m2 and the median age was 59 years. Of 68 DXA scans performed, osteopenia and osteoporosis were present in 32.4% and 2.9%, respectively. In all, 62 lumbar scans were analyzed using TBS. The mean TBS value was 1.386±0.140, and 32.2% of the results were below 1.310. TBS values correlated negatively with BMI (mainly above 30kg/m2), age (mainly above 60 years), and glycemia, while abnormal TBS correlated with osteopenia, T2DM, low impact fracture, and menopause. Six female patients had low impact fractures, which were associated with a lower TBS (1.178±0.065 vs. 1.404±0.130 in the group without fractures, p<0.001), greater age, higher BMI, impaired renal function, abnormal glycemia, and osteopenia. CONCLUSION: This study suggested that known risk factors for bone loss compromise the bone microarchitecture of individuals with PsH, despite DXA results. PsH menopausal women, PsH patients who are older, osteopenic and have a higher BMI or T2DM may be candidates for a more detailed assessment using, for example, TBS.