Vol.:(0123456789) 1 3 Calcifed Tissue International https://doi.org/10.1007/s00223-020-00749-5 ORIGINAL RESEARCH Usefulness of Dual X‑ray Absorptiometry‑Derived Bone Geometry and Structural Indexes in Mastocytosis Fabio Massimo Ulivieri 1,2  · Luca Rinaudo 3  · Luca Petruccio Piodi 4  · Valentina Barbieri 5  · Giorgio Marotta 1  · Mariarita Sciumè 6  · Federica Irene Grifoni 6  · Bruno Mario Cesana 7 Received: 25 May 2020 / Accepted: 11 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Reduced bone mass with or without fragility fractures is a common feature of mastocytosis, particularly in adult males. However, bone mineral density does not account for all the fragility fractures, being a part of them attributable to impair- ment in bone quality. Aim of this study is to assess the usefulness of DXA-derived geometry and structural indexes in the assessment of bone status in mastocytosis. Ninety-six consecutive patients (46 women and 50 men) afected by cutaneous (CM) or systemic (SM) mastocytosis were studied. Mean age (± SD) was 53.3 ± 14.23. Spine lateral X-rays for Genant’s scale, DXA for lumbar (L) and femoral (F) bone mineral density (BMD), bone strain index (BSI), lumbar trabecular bone score (TBS), and hip structural analysis (HSA) were performed. Among the laboratory variables, data of serum tryptase were reported. Tryptase was higher in SM (p = 0.035), inversely correlated with LBMD (r = − 0.232; p = 0.022) and TBS (r = − 0.280; p = 0.005), and directly with L-BSI (r = 0.276; p = 0.006). L-BSI remained statistically signifcant (p = 0.006; adjusted R 2 = 0.101) together with mastocytosis (SM or CM: p = 0.034) in the multivariate regression model with tryptase as dependent variable, being LBMD and TBS not statistically signifcant (p = 0.887, and p = 0.245, respectively). Tryptase increased about 22 units for each unit increase of L-BSI and about 18 units for SM against CM. L-BSI was lower (p = 0.012), while FN-BSI and FT-BSI were higher in women (p < 0.001) than in men. HSA indexes were signifcantly higher in men, particularly with SM. SM is a risk factor for reduced bone mass, texture and strength. Since mean L-BSI and Z-modulus of all the femoral sites are statistically higher in men than in female, it could be argued that men have a better femoral bone resistance to bending forces than women, but a worse lumbar bone resistance to compressive loads. DXA indexes of bone quality are useful in mastocytosis’ bone assessment and its clinical management. Keywords Mastocytosis · DXA · BMD · BSI · HSA · TBS * Fabio Massimo Ulivieri ulivieri@gmail.com Luca Rinaudo lrinaudo@hologicitalia.com Valentina Barbieri valentina.barbieri@unimi.it Giorgio Marotta giorgio.marotta@policlinico.mi.it Mariarita Sciumè mariarita.sciume@policlinico.mi.it Federica Irene Grifoni federica.grifoni@policlinico.mi.it Bruno Mario Cesana brnmrcesana@gmail.com 1 U.O. Medicina Nucleare, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milano, Italy 2 Present Address: U.O. Endocrinologia, Università Vita-Salute San Rafaele, via Olgettina 58, 20132 Milano, Italy 3 TECHNOLOGIC Srl, Lungo Dora Voghera, 34/36, 10153 Torino, Italy 4 Milano, Italy 5 Scuola Di Specializzazione in Medicina Fisica e Riabilitativa, Università Degli Studi Di Milano, Via Festa del Perdono, 7, 20122 Milano, Italy 6 U.O. Ematologia, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milano, Italy 7 Unità Di Statistica Medica, Biometria e, Bioinformatica “Giulio A. Maccacaro”, Dipartimento Di Scienze Cliniche E Salute Della Comunità, Università Degli Studi Di Milano, Via Vanzetti, 5, 20100 Milano, Italy