Body composition, trabecular bone score and vertebral fractures in subjects with Klinefelter syndrome

• Published in: Journal of endocrinological investigation 2023-02, Vol.46 (2), p.297-304
• Main Authors: Vena, W., Carrone, F., Delbarba, A., Akpojiyovbi, O., Pezzaioli, L. C., Facondo, P., Cappelli, C., Leonardi, L., Balzarini, L., Farina, D., Pizzocaro, A., Lania, A. G., Mazziotti, G., Ferlin, A.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Adolescent; Adult; Body Composition; Body fat; Body mass index; Body measurements; Bone composition; Bone Density; Bone mass; Bone mineral density; Bone strength; Cancellous bone; Cancellous Bone - diagnostic imaging; Cross-Sectional Studies; Dual energy X-ray absorptiometry; Endocrinology; Femur Neck; Fractures; Hormone replacement therapy; Humans; Internal Medicine; Klinefelter Syndrome - complications; Klinefelter Syndrome - epidemiology; Klinefelter Syndrome - metabolism; Klinefelter's syndrome; Lumbar Vertebrae - metabolism; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Morphometry; Original Article; Osteoporotic Fractures - diagnosis; Spinal Fractures - diagnostic imaging; Spinal Fractures - epidemiology; Spinal Fractures - etiology; Spine (lumbar); Testosterone; Testosterone - metabolism; Vertebrae; Young Adult
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-022-01901-8

Background Klinefelter syndrome (KS) frequently causes skeletal fragility characterized by profound alterations in bone microstructure with increased risk of fractures. Increased body fat mass associated with decreased body lean mass are frequent features of KS with possible detrimental effects on skeletal health. In this cross-sectional study, we evaluated the associations between body composition parameters, vertebral fractures (VFs) and trabecular bone score (TBS) in adult subjects with KS. Methods Seventy-one adult males (median age 41 years, range 18–64) with 47, XXY KS were consecutively enrolled by two Endocrinology and Andrology Units (IRCCS Humanitas Research Hospital in Milan and ASST Spedali Civili in Brescia). Dual-energy X-ray absorptiometry (DXA) was performed to assess bone mineral density (BMD) at lumbar spine, femoral neck and total hip, TBS and body composition. Prevalence of VFs was assessed by quantitative morphometry on lateral spine X-rays. Results VFs were detected in 14 patients (19.7%), without significant association with low BMD ( p  = 0.912). In univariate logistic regression analysis, VFs were significantly associated with truncal/leg fat ratio (OR 2.32 per tertile; 95% CI 1.05–5.15; p  = 0.038), whereas impaired TBS (detected in 23.4% of subjects) was associated with older age at study entry ( p  = 0.001) and at diagnosis of disease ( p  = 0.015), body mass index (BMI; p  = 0.001), waist circumference ( p  = 0.007), fat mass index (FMI; p