Bone material properties are impaired in postmenopausal women with T2D as determined by reference point indentation. The results suggest a role for the accumulation of AGEs to account for inferior BMSi in T2D.

Long-term, continuous therapy of hypoparathyroidism for 6 years with rhPTH(1-84) is associated with reductions in supplemental calcium and calcitriol requirements, stable serum calcium concentration, and reduced urinary calcium excretion. The safety profile remains good. These data represent the longest experience with the therapeutic use of PTH for any condition and demonstrate its long-term efficacy and safety in hypoparathyroidism.

PTH(1-84) treatment of hypoparathyroidism for up to 4 yr maintains the serum calcium concentration, while significantly reducing supplemental calcium and 1,25-dihydroxyvitamin D requirements. Lumbar spine BMD increases without significant changes at other sites. These data provide support for the safety and efficacy of PTH(1-84) therapy in hypoparathyroidism for up to 4 yr.

In the 1970s, with the advent of biochemical multichannel screening in the United States and other western countries, the clinical presentation of primary hyperparathyroidism (PHPT) changed from a symptomatic to an asymptomatic disorder. However, in Asian countries, like China, PHPT did not show this evolution, but rather continued to be a symptomatic disease with target organ involvement. In this paper, we revisit the clinical features of PHPT in New York and Shanghai, representative United States and Chinese cites, over the past decade. The questions we address are whether the disease evolved in China to a more asymptomatic one and, whether in the United States further changes are evident. The results indicate that while PHPT continues to present primarily as an asymptomatic disease in the United States, a new phenotype characterized by normal serum calcium and high parathyroid hormone levels, normocalcemic PHPT, has emerged. Data from Shanghai demonstrates a trend for PHPT to present more commonly as an asymptomatic disorder in China. However, most patients with PHPT in China still manifest classical symptoms, i.e. nephrolithiasis and fractures. A comparison of the two cohorts shows that Chinese patients with PHPT are younger, with higher serum calcium and PTH levels, and lower 25-hydroxyvitamin D levels than patients in New York. Normocalcemic PHPT has not yet been recognized in Shanghai. In summary, although the phenotypes of PHPT in both cities are evolving towards less evident disease, sharp clinical and biochemical differences are still apparent in PHPT as expressed in China and the United States. Keywords: normocalcemic primay hyperparathyroidism; asymptomatic; symptomatic Bone Research (2013) 2: 162-169. doi: 10.4248/BR201302005 IntroductionIn countries that began to utilize the multichannel biochemical screening test in the 1970s, the presentation of primary hyperparathyroidism (PHPT) changed from a disease that was classically symptomatic with "stones, bones, moans and groans" to a contemporary asymptomatic disorder ( 1). While this clinical evolution was apparent in the United States and other Western countries, in Asian countries, such as India and China, In this paper, we review the more recent experience in two cities, Shanghai and New York, with the central question: has the clinical expression of PHPT changed in these countries over the past 10 years? MethodsThe cohort from Shanghai has recently been reported (4). These subjects form the basis for the description of the more recent experience in China. In the United States, an ongoing new cohort of subjects since 2010 form the basis of the New York experience, along with a published experience of subjects who present with normocalcemic PHPT (5-6). As opposed to asymptomatic cases, symptomatic PHPT refers to symptoms related with hypercalcemia, such as skeletal and renal diseases, neuromuscular, gastrointestinal, articular, hematologic, cardiovascular and central nervous system manifestations. Statistical analysesAll statistical analyses were pe...

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