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. 2024 Oct 25;13(21):6382.
doi: 10.3390/jcm13216382.

Analysis of Bone Phenotype Differences in MEN1-Related and Sporadic Primary Hyperparathyroidism Using 3D-DXA

Anna K Eremkina  1 , Svetlana V Pylina  1 , Alina R Elfimova  1 , Anna M Gorbacheva  1 , Ludovic Humbert  2 , Mirella López Picazo  2 , Angelina V Hajrieva  1 , Ekaterina N Solodovnikova  1 , Liliya D Kovalevich  1 , Ekaterina A Vetchinkina  1 , Ekaterina V Bondarenko  1 , Natalia V Tarbaeva  1 , Natalia G Mokrysheva  1
Affiliations

Analysis of Bone Phenotype Differences in MEN1-Related and Sporadic Primary Hyperparathyroidism Using 3D-DXA

Anna K Eremkina et al. J Clin Med. .

Abstract

Background: The rarity and variability of MEN1-related primary hyperparathyroidism (mPHPT) has led to contradictory data regarding the bone phenotype in this patient population. Methods: A single-center retrospective study was conducted among young age- and sex-matched patients with mPHPT and sporadic hyperparathyroidism (sPHPT). The main parameters of calcium-phosphorus metabolism, bone remodeling markers, and bone mineral density (BMD) measurements were obtained during the active phase of hyperparathyroidism before parathyroidectomy (PTE) and 1 year after. Trabecular Bone Score (TBS) and 3D-DXA analysis of the proximal femur were used to evaluate the differences in bone architecture disruption between groups. Results: Patients with mPHPT had significant lower preoperative BMD compared to sPHPT at lumbar spine-LS (p = 0.002); femur neck-FN (p = 0.001); and total hip-TH (p = 0.002). 3D-DXA analysis showed the prevalence of cortical rather than trabecular bone damage in mPHPT compared to sPHPT: cortical thickness (p < 0.001); cortical surface BMD (p = 0.001); cortical volumetric BMD (p = 0.007); and trabecular volumetric BMD (p = 0.029). One year after, PTE DXA and 3D-DXA parameters were similar between groups, while 3D-visualisation showed more extensive regeneration in cortical sBMD and cortical thickness in mPHPT. Conclusions: mPHPT is associated with lower preoperative BMD values with predominant architecture disruption in the cortical bone. The absence of differences in DXA and 3D-DXA parameters 1 year after PTE between mPHPT/sPHPT combined with significantly lower BMD in mPHPT at the initial stage may indicate faster bone recovery after surgery in mPHPT than in sPHPT.

Keywords: 3D-DXA; BMD; MEN1; MEN1-related primary hyperparathyroidism; multiple endocrine neoplasia type 1.

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Conflict of interest statement

Ludovic Humbert is an employee and stockholder of 3D-SHAPER Medical. Mirella López Picazo is an employee of 3D-SHAPER Medical. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the included patients with MEN1-related (mPHPT) and sporadic hyperparathyroidism (sPHPT). PTE—parathyroidectomy.
Figure 2
Figure 2
3D visualization of the percentage difference in cortical bone between mPHPT and sPHPT before parathyroidectomy. (a) Cortical sBMD; (b) Cortical thickness; (c) Cortical vBMD. Lower values of mPHPT compared to sPHPT are shown in yellow-red, no difference is shown in gray. mPHPT (MEN1-related primary hyperparathyroidism); sPHPT (sporadic primary hyperparathyroidism).
Figure 3
Figure 3
Cross-sectional images showing the difference in cortical and trabecular vBMD between mPHPT and sPHPT before surgery. Lower values of mPHPT compared to sPHPT are shown in yellow-red. (a) Mid-coronal section; (b) Neck section; (c) Intertrochanteric section; (d) Lower shaft section). mPHPT (MEN1-related primary hyperparathyroidism); sPHPT (sporadic primary hyperparathyroidism).
Figure 4
Figure 4
3D visualization of the percentage change in cortical bone in the mPHPT and sPHPT groups 1 year after parathyroidectomy. (a) Cortical sBMD; (b) Cortical thickness; (c) Cortical vBMD. Increase is shown in blue-green color, decrease is shown in yellow-red color, NS—no difference is shown in gray color. mPHPT (MEN1-related primary hyperparathyroidism); sPHPT (sporadic primary hyperparathyroidism).
Figure 5
Figure 5
Cross-sectional images showing changes in cortical and trabecular vBMD in both groups 1 year after surgery (increase is shown in blue-green color, decrease is shown in yellow-red color, no difference is shown in black color). (a) Mid-coronal section; (b) Neck section; (c) Intertrochanteric section; (d) Lower shaft section. mPHPT (MEN1-related primary hyperparathyroidism); sPHPT (sporadic primary hyperparathyroidism).
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