Unraveling the relationship between serum parathyroid hormone levels and trabecular bone score: a cross-sectional study

Abstract

The TBS is a new method for clinicians to assess the bone quality. It is directly related to the mechanical strength of bone and helps predict fracture risk. The present analysis aimed to investigate the associations between serum PTH levels and TBS by analyzing data from the National Health and Nutrition Examination Survey (NHANES). A total of 3516 participants from the NHANES 2005-2006 were included in this cross-sectional study. The independent variable was serum PTH, and the outcome variable was TBS. The associations of serum PTH levels with TBS were examined using multivariable linear regression models. After adjusting for covariates, there was a negative association between serum PTH level and TBS (β = - 0.0034; 95% confidence interval, - 0.0050 to - 0.0017). However, in the subgroup analysis stratified by gender, race, and age, this association became negative only in Non-Hispanic White (β = - 0.0047, 95% CI: - 0.0071 to - 0.0048) and young people (age < 60) (β = - 0.0036, 95% CI: - 0.0057, - 0.0016), regardless of gender. In addition, the association of serum PTH with TBS was an U-shaped curve, with a point of inflection at 6.71 pmol/L. This study showed that serum PTH level was negatively associated with TBS. Maintaining PTH levels in a lower reasonable clinical range may be beneficial to bone health, especially for young non-Hispanic white.

Figure 1

Flowchart of sample selection.

Figure 2

The relationship between the serum PTH and TBS. (A) Each black point represents a sample. (B) Solid rad line represents the smooth curve fit between variables. Blue bands represent the 95% of confidence interval from the fit. Age, Sex, Race, PIR, BMI, Total spine BMD, Alkaline phosphatase, Blood urea nitrogen, Total Cholesterol, Total protein, Serum uric acid, Calcium, Creatinine, Phosphorus, HDL-C, LDL-C, CRP, Vit D, Alcohol, Coronary heart disease, Physical activity, Cancer, Smoking were adjusted.

Figure 3

The association between serum PTH and TBS, stratified by gender. Age, Race, PIR, BMI, Total spine BMD, Alkaline phosphatase, Blood urea nitrogen, Total Cholesterol, Total protein, Serum uric acid, Calcium, Creatinine, Phosphorus, HDL-C, LDL-C, CRP, Vit D, Alcohol, Coronary heart disease, Physical activity, Cancer, Smoking were adjusted.

Figure 4

The association between PTH and TBS, stratified by age. Gender, Race, PIR, BMI, Total spine BMD, Alkaline phosphatase, Blood urea nitrogen, Total Cholesterol, Total protein, Serum uric acid, Calcium, Creatinine, Phosphorus, HDL-C, LDL-C, CRP, Vit D, Alcohol, Coronary heart disease, Physical activity, Cancer, Smoking were adjusted.

Figure 5

The association between serum PTH and TBS, stratified by ethnicity. Age, Sex, PIR, BMI, Total spine BMD, Alkaline phosphatase, Blood urea nitrogen, Total Cholesterol, Total protein, Serum uric acid, Calcium, Creatinine, Phosphorus, HDL-C, LDL-C, CRP, Vit D, Alcohol, Coronary heart disease, Physical activity, Cancer, Smoking were adjusted.