Endocrine Abstracts

The Trabecular Bone Score (TBS) has recently been developed through the grayscale textural analysis of Dual-Energy X-ray Absorptiometry (DXA) images. Due to its capability to evaluate the microarchitectural texture of bone, TBS proves valuable in the assessment of bone quality. While the clinical relevance of TBS has been partially confirmed in relation to hormonal disorders, there is currently a lack of precise data regarding its application during specific phases of treatment for individuals with Graves’ Orbitopathy (GO) undergoing high-dose glucocorticoid (GS) therapy. The objective of this investigation was to assess the utility of TBS testing and specific bone turnover markers at various stages of GO treatment. This evaluation aimed to identify their practical value in routine clinical practice. Between 2020 and 2023, the study focused on a cohort of 47 patients experiencing active moderate-to-severe GO who underwent treatment with intravenous methylprednisolone (MP). Within a subset of 29 patients treated from 2020 to 2022, the study evaluated the therapeutic effects on TBS, Lumbar Spine Bone Mineral Density (LS BMD), and Femoral Neck Bone Mineral Density (FN BMD). Another subgroup consisting of 42 patients treated during the same period underwent an assessment of therapy impact on specific markers, including sclerostin (SCL), osteoprotegerin (OPG), osteocalcin (OC), and N-terminal telopeptide of type I collagen (NTX). BMS and TBS assessments were conducted immediately prior to the initiation of treatment and two months following the administration of the final dose of MP. Measurements of bone turnover markers were taken at the onset of treatment, preceding the sixth MP dose, subsequent to the 12th MP dose, and two months post the final MP dose. Within the cohort receiving treatment, statistically notable alterations in LS BMD and TBS were identified, showing a rise of 3% and 0.7%, respectively. Furthermore, within the subset of patients undergoing marker assessments, a decline in the average concentrations of SCL, OPG, NTX was noted, along with an increase in OC concentration. The findings from the conducted study indicate that BMD TBS exhibit comparable responses to high-dose corticosteroid therapy in individuals with thyroid orbitopathy. It has been verified that the use of MP in the treatment of thyroid orbitopathy leads to alterations in the rate of bone turnover. Given these observations, patients undergoing planned or ongoing MP therapy necessitate continual clinical assessment and enhanced diagnostic scrutiny to evaluate the risk of osteoporotic fractures and implement suitable preventive measures.