ArticleThe Journal of clinical endocrinology and metabolism2021
DXA-Based Bone Strain Index: A New Tool to Evaluate Bone Quality in Primary Hyperparathyroidism.
Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 25 citations in OpenAlex.
- Disorganized bone collagen fibers in early-stage type 2 diabetes mellitus and its association with adipose tissue redistribution.European radiology experimental · 2026Article
- Digital tomosynthesis derived textural and geometric measures of vertebral bone quality in postmenopausal women with primary hyperparathyroidism.Journal of endocrinological investigation · 2026Article
- Bone Disease in Primary Hyperparathyroidism.Journal of musculoskeletal & neuronal interactions · 2025Review
- Integration of Multi-Scale Predictive Tools of Bone Fragility: A Structural and Material Property Perspective.Materials (Basel, Switzerland) · 2025Review
- Bone in Parathyroid Diseases Revisited: Evidence From Epidemiological, Surgical and New Drug Outcomes.Endocrine reviews · 2025Review
- Advanced radiomic prediction of osteoporosis in primary hyperparathyroidism: a machine learning-based analysis of CT images.La Radiologia medica · 2025Article
- Osteoporosis and Normocalcemic Primary Hyperparathyroidism (Conservatively or Surgically Managed).Journal of clinical medicine · 2024Review
- DXA beyond bone mineral density and the REMS technique: new insights for current radiologists practice.La Radiologia medica · 2024Review
- Usefulness of DXA-based bone strain index in postmenopausal women with type 2 diabetes mellitus.Archives of osteoporosis · 2024Article
- Generation and Validation of Normative, Age-Specific Reference Curves for Bone Strain Index in Women.Diagnostics (Basel, Switzerland) · 2024Article
- Bone quality in endocrine diseases: determinants and clinical relevance.Journal of endocrinological investigation · 2023Review
- Assessment of DXA derived bone quality indexes and bone geometry parameters in early breast cancer patients: A single center cross-sectional study.Bone reports · 2023Article
- DXA-based bone strain index in normocalcemic primary hyperparathyroidism.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Article
- Bone Strain Index: preliminary distributional characteristics in a population of women with normal bone mass, osteopenia and osteoporosis.La Radiologia medica · 2022Article
- Osteosarcopenia-The Role of Dual-Energy X-ray Absorptiometry (DXA) in Diagnostics.Journal of clinical medicine · 2022Review
- Secondary Osteoporosis and Metabolic Bone Diseases.Journal of clinical medicine · 2022Review
- The Bone Strain Index: An Innovative Dual X-ray Absorptiometry Bone Strength Index and Its Helpfulness in Clinical Medicine.Journal of clinical medicine · 2022Review
- Hip Structural Analysis and Bone Strain Index in Clinical Practice: Their Utility Beyond BMD.Indian journal of endocrinology and metabolismReview
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextPrimary hyperparathyroidism (PHPT) is associated with impaired bone quality and increased fracture risk. Reliable tools for the evaluation of bone quality parameters are not yet clinically available. Bone Strain Index (BSI) is a new metric for bone strength based on Finite Element Analysis from lumbar spine and femoral neck dual-energy x-ray absorptiometry (DXA) images.
objectiveTo assess the lumbar spine (LS), femoral neck (FN), and total hip (TH) BSI in PHPT patients compared with controls and to investigate the association of BSI with vertebral fractures (VFs) in PHPT.
methodsThis case-control study enrolled 50 PHPT patients and 100 age- and sex-matched control subjects from an outpatient clinic. The main outcome measures were LS-BSI, FN-BSI, and TH-BSI.
resultsFN bone mineral density (BMD) and one-third distal radius BMD were lower in the PHPT group than in controls (FN 0.633 ± 0.112 vs 0.666 ± 0.081, P = 0.042; radius 0.566 ± 0.07 vs 0.625 ± 0.06, P < 0.001). PHPT group has significant lower TBS score compared with controls (1.24 ± 0.09 vs 1.30 ± 0.10, P < 0.001). BSI was significantly higher at LS (2.28 ± 0.59 vs 2.02 ± 0.43, P = 0.009), FN (1.72 ± 0.41 vs 1.49 ± 0.35, P = 0.001), and TH (1.51 ± 0.33 vs 1.36 ± 0.25, P = 0.002) in PHPT. LS-BSI showed moderate accuracy for discriminating VFs (AUC 0.667; 95% CI, 0.513-0.820). LS-BSI ≥ 2.2 and was a statistically significant independent predictor of VFs, with an adjusted odds ratio ranging from 5.7 to 15.1.
conclusionBSI, a DXA-derived bone quality index, is impaired in PHPT and may help to identify PHPT subjects at high risk of fractures.
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