Phalangeal Quantitative Ultrasound and Bone Mineral Density in Evaluating Cortical Bone Loss: A Study in Postmenopausal Women With Primary Hyperparathyroidism and Subclinical Iatrogenic Hyperthyroidism

Abstract 

Twenty-five postmenopausal women with primary hyperparathyroidism (PHPT) and 30 age-matched women with subclinical hyperthyroidism (sHTH) were studied to assess cortical bone loss. One hundred two healthy women were also recruited. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at lumbar spine (LS), femoral neck (FN) and femoral total (FT), and at one-third of the radius (R). Amplitude-dependent speed of sound (ADSoS) and Ultrasound Bone Profile Index (UBPI) were also evaluated using phalangeal quantitative ultrasound (QUS). A significant correlation was found between QUS and BMD at LS (ADSoS, p<0.05) and R (ADSoS and UBPI, p<0.001) in controls. QUS significantly correlated with BMD at LS, FN (p<0.01), and FT (p<0.001) in sHTH. No correlations were found in the PHPT group. Mean T-score values of all parameters were significantly lower in patients compared with controls (p<0.001); however, they did not differ between PHPT and sHTH patients. T-score of R, ADSoS, and UBPI was reduced compared with other sites (p<0.001) in both diseases. In postmenopausal women with PHPT and sHTH, bone loss is mainly detectable at cortical level. However, qualitative and/or structural changes of bone could account for the lack of correlations between these 2 techniques at cortical sites.

Key Words: Bone mineral density, phalangeal quantitative ultrasound, primary hyperparathyroidism, subclinical hyperthyroidism