Bone Measurements in Asymptomatic Primary Hyperparathyroidism

Adami, Silvano; Braga, V.; Squaranti, R; Rossini, Maurizio; Gatti, Davide; Zamberlan, N.

doi:10.1016/s8756-3282(98)00042-8

Cited by 54 publications

(34 citation statements)

References 18 publications

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“…Indeed z-score values for BMD measured on these three sites were −0.66, −0.66, and −0.67, The involvement of trabecular bone in PHPT is still debated. Some authors found that bone enriched in trabecular bone is affected to the same extent as bone enriched in cortical bone in PHPT [6,7,15], in accordance with our own results. At the opposite end, other authors did not find any involvement of trabecular bone [3][4][5].…”

Section: Discussionsupporting

confidence: 92%

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Bone Ultrasonometry and Turnover Markers in Primary Hyperparathyroidism

Cortet

Blanckaert

et al. 2000

Calcified Tissue International

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Quantitative ultrasound (QUS) of bone and new markers of bone remodeling have been poorly investigated in mild primary hyperparathyroidism (PHPT). In this study 26 patients (20 females and 6 males) were evaluated. BUA and SOS were measured by QUS at the heel. Markers of bone remodeling assessed were bone alkaline phosphatase (BAP), osteocalcin (OC), procollagen type I N- and C-terminal propeptides (PINP et PICP), and procollagen type I C-terminal telopeptide in blood and urine (ICTP and CTX). Bone mineral density (BMD) was measured at the lumbar spine (LS), femoral neck (FN), and Ward's triangle (WT). The control group comprised 35 sex- and age-matched subjects. The statistically significant variables between the two groups were (P < 0.05) BUA, BMD(LS), BMD(FN), BMD(WT), BAP, and OC. Corresponding z-scores were -0.55 +/- 0.75, -0.66 +/- 0.77, -0.66 +/- 0.71, -0.67 +/- 0.52, 1.87 +/- 3.87, and 1.93 +/- 3.53, respectively. Although PICP and PINP levels were higher in PHPT patients as compared with controls, the difference was not significant. Several markers of bone turnover were moderately correlated with both QUS (r = -0.39 to -0.55) and BMD (r = -0.48 to 0.63). In conclusion QUS seems to be a relevant tool in the assessment of bone status for patients with mild PHPT.

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Section: Discussionsupporting

confidence: 92%

“…However, data are more conflicting concerning the measurement of BMD at skeletal sites enriched in trabecular bone. Some authors have found normal BMD [3][4][5] and others have found a mild decrease [6,7]. In addition, there are some controversies over the occurrence of bone loss in untreated PHPT [6,8].…”

mentioning

confidence: 99%

Bone Ultrasonometry and Turnover Markers in Primary Hyperparathyroidism

Cortet

Blanckaert

et al. 2000

Calcified Tissue International

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“…(2,5,(7)(8)(9) At peripheral sites, alterations of cortical bone geometry have been found consistent with periosteal bone apposition and endocortical bone resorption. (10)(11)(12)(13) Overall, effects appear detrimental to bone integrity as patients with PHPT have been found to have an increased risk of fracture. (14,15) Whereas areal bone mineral density (aBMD) as assessed by dual-energy X-ray absorptiometry (DXA) increases following successful parathyroidectomy (PTX), (16) data regarding effects on other determinants of bone strength such as bone geometry and cancellous bone architecture are scarce.…”

Section: Introductionmentioning

confidence: 99%

Parathyroidectomy improves bone geometry and microarchitecture in female patients with primary hyperparathyroidism: A one-year prospective controlled study using high-resolution peripheral quantitative computed tomography

Hansen

Hauge

Rasmussen

et al. 2012

Journal of Bone and Mineral Research

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Following parathyroidectomy (PTX), bone mineral density (BMD) increases in patients with primary hyperparathyroidism (PHPT), yet information is scarce concerning changes in bone structure and strength following normalization of parathyroid hormone levels postsurgery. In this 1-year prospective controlled study, high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to evaluate changes in bone geometry, volumetric BMD (vBMD), microarchitecture, and estimated strength in female patients with PHPT before and 1 year after PTX, compared to healthy controls. Twenty-seven women successfully treated with PTX (median age 62 years; range, 44-75 years) and 31 controls (median age 63 years; range, 40-76 years) recruited by random sampling from the general population were studied using HR-pQCT of the distal radius and tibia as well as with dual-energy X-ray absorptiometry (DXA) of the forearm, spine, and hip. The two groups were comparable with respect to age, height, weight, and menopausal status. In both radius and tibia, cortical (Ct.) vBMD and Ct. thickness increased or were maintained in patients and decreased in controls (p < 0.01). Radius cancellous bone architecture was improved in patients through increased trabecular number and decreased trabecular spacing compared with changes in controls (p < 0.05). No significant cancellous bone changes were observed in tibia. Estimated bone failure load by finite element modeling increased in patients in radius but declined in controls (p < 0.001). Similar, albeit borderline significant changes in estimated failure load were found in tibia (p ¼ 0.06). This study showed that females with PHPT had improvements in cortical bone geometry and increases in cortical and trabecular vBMD in both radius and tibia along with improvements in cancellous bone architecture and estimated strength in radius 1 year after PTX, reversing or attenuating age-related changes observed in controls. ß

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“…Such changes in HPT, however, have been replaced by characteristic findings of an increased bone turnover, which mostly reduces the cortical bone and the appendicular skeleton (Christiansen et al 1997, Parisien et al 1990, Parfitt et al 1991, Grey et al1994. Both the endostal resorption and the periostal apposition seem to be increased, and the imbalance between them decreases the cortical thickness (Adami et al 1998). Patients with HPT have demonstrated reduced BMD in the distal forearm , Larsson et al 1989) and in the femoral neck , while the findings in the spine are divergent , Block et al 1989, Grey et al 1994).…”

Section: Skeletal Symptoms Of Hptmentioning

confidence: 99%

Primary Hyperparathyroidism of Postmenopausal Women

Lundgren¹

1999

Upsala Journal of Medical Sciences

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Bone Measurements in Asymptomatic Primary Hyperparathyroidism

Cited by 54 publications

References 18 publications

Bone Ultrasonometry and Turnover Markers in Primary Hyperparathyroidism

Bone Ultrasonometry and Turnover Markers in Primary Hyperparathyroidism

Parathyroidectomy improves bone geometry and microarchitecture in female patients with primary hyperparathyroidism: A one-year prospective controlled study using high-resolution peripheral quantitative computed tomography

Primary Hyperparathyroidism of Postmenopausal Women

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