Evaluation of the trabecular bone score in 35 children and adults with X-linked hypophosphatemic rickets

• Published in: Journal of bone and mineral metabolism Vol. 41; no. 5; pp. 666 - 672
• Main Authors: de Paula Colares Neto, Guido, Pereira, Rosa Maria Rodrigues, Alvarenga, Jackeline Couto, Takayama, Liliam, de Assis Funari, Mariana Ferreira, Martin, Regina Matsunaga
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.09.2023; Springer Nature B.V
• Subjects: Bone growth; Bone mineral density; Cancellous bone; Children; Dual energy X-ray absorptiometry; Hypophosphatemia; Medicine; Medicine & Public Health; Metabolic Diseases; Original Article; Orthopedics; Osteogenesis; Rickets; Spine (lumbar); Bone mineral density; X-linked hypophosphatemic rickets; Trabecular bone score; DXA
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-023-01442-x

Introduction  The aim of this study is to evaluate and compare the trabecular bone scores (TBSs) of 11 children and 24 adults with X-linked hypophosphatemic rickets (XLH) and non-XLH subjects from a tertiary center. Materials and methods  The areal bone mineral density at the lumbar spine (LS-aBMD) and LS-aBMD Z score were analyzed by dual-energy X-ray absorptiometry. The bone mineral apparent density (BMAD) and LS-aBMD Z score adjusted for height Z score (LS-aBMD–HAZ) were calculated. The TBS was determined using TBS iNsight software based on DXA images from the Hologic QDR 4500 device. Results The XLH patients exhibited a higher mean LS-aBMD Z score, BMAD, and TBS than the non-XLH subjects ( p  < 0.01). LS-aBMD–HAZ and BMAD were greater in the XLH children than those in their corresponding non-XLH subjects ( p  < 0.01 and p  = 0.02), and the XLH children trended toward a greater TBS ( p  = 0.06). The XLH adults had a higher LS-aBMD Z score, BMAD, and TBS than the non-XLH subjects ( p  < 0.01). When stratified by metabolic status according to the serum values of bone formation markers, compensated adult patients had a higher LS-aBMD Z score, BMAD, and TBS than non-XLH subjects ( p  < 0.01). Noncompensated patients had higher LS-aBMD Z scores and BMAD results than non-XLH subjects. However, TBS values did not differ statistically significantly between those groups ( p  = 0.45). Conclusion The higher LS-aBMD Z score, BMAD, and TBS result in the XLH patients compared to non-XLH subjects indicates an increased amount of trabecular bone within the lumbar spine, regardless of extraskeletal calcifications.