Identification of independent factors affecting bone mineral density after successful parathyroidectomy for symptomatic hyperparathyroidism

Abstract

Background Studies have shown that the response of bone mineral density (BMD) to parathyroidectomy for symptomatic primary hyperparathyroidism (PHPT) is heterogeneous and difficult to predict. However, the independent factors affecting BMD in PHPT patients after parathyroidectomy remains limited and inconclusive. This study aimed to explore the independent factors affecting BMD changes in symptomatic PHPT patients after parathyroidectomy. Methods This study retrospectively analyzed 105 patients with symptomatic PHPT treated at Beijing Jishuitan Hospital between January 2010 and December 2015. The primary outcome was a > 10% increase in BMD at 3 years after parathyroidectomy compared with the preoperative value, whereas the secondary outcomes were BMD changes at various measurement sites. Results A total of 105 patients with a mean age of 46.37 years were included in this study. Univariate logistic regression analysis indicated that hypertension (odds ratio [OR[: 0.032; 95% confidence interval [CI]: 0.001–0.475; P = 0.012), and parathyroid hormone level (OR: 1.006; 95% CI: 1.004–1.009; P = 0.044) were associated with the > 10% BMD increase. However, these results were not significant after adjustments for potential confounders. Moreover, the BMD values at the lumbar spine, femoral neck, femoral trochanter, Ward’s triangle, and whole body after parathyroidectomy were significantly greater than those before the operation (P < 0.05). Conclusions This study suggests that patient characteristics were not associated with the > 10% BMD increase. However, the BMD values of the femur and lumbar spine were significantly increased in symptomatic PHPT patients after parathyroidectomy.

Characteristics, Management and Outcomes of Primary Hyperparathyroidism from 2009 to 2021: a single centre report from South Africa.

“…The observation that post-operative increase in BMD was only signi cant at the spine is in keeping with results of recent studies from China with similar follow-up intervals (37,38). This may be explained by rates of bone turnover being higher in cancellous bone, resulting in rapid and lasting improvement in BMD (37,38).…”

“…The observation that post-operative increase in BMD was only signi cant at the spine is in keeping with results of recent studies from China with similar follow-up intervals (37,38). This may be explained by rates of bone turnover being higher in cancellous bone, resulting in rapid and lasting improvement in BMD (37,38). However, since less than 24% of patients had repeat BMD measurements post-operatively, the results need to be interpreted with caution and requires further investigation.…”

Characteristics, management and outcomes of primary hyperparathyroidism from 2009 to 2021: a single centre report from South Africa

“…The observation that post-operative increase in BMD was only significant at the spine is in keeping with results of recent studies from China with similar follow-up intervals [ 43 , 44 ]. This may be explained by rates of bone turnover being higher in cancellous bone, resulting in rapid and lasting improvement in BMD [ 43 , 44 ].…”

“…The observation that post-operative increase in BMD was only significant at the spine is in keeping with results of recent studies from China with similar follow-up intervals [ 43 , 44 ]. This may be explained by rates of bone turnover being higher in cancellous bone, resulting in rapid and lasting improvement in BMD [ 43 , 44 ]. However, since less than 24% of patients had repeat BMD measurements post-operatively, the results need to be interpreted with caution and requires further investigation.…”