Effect of parathyroidectomy for primary hyperparathyroidism on bone mineral density in postmenopausal women

Sitges‐Serra, Antonio; Garcí­a, Luis Miguel Tanarro; Prieto, Rosa; Peña, María J.; Nogués, Xavier; Sancho, José Luis Valero

doi:10.1002/bjs.7044

Cited by 34 publications

(33 citation statements)

References 24 publications

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“…Also in osteopenic women, primary hyperparathyroidism was the most commonly diagnosed disease. Our observations are in line with the epidemiological evidence showing that women are about 3 times more often affected by primary hyperparathyroidism than men 34,35,36 . Therefore, our results emphasize the importance of serum calcium screening in all subjects with osteoporosis or reduced bone mass.…”

Section: Rheumatologysupporting

confidence: 92%

Secondary Osteoporosis in Men and Women: Clinical Challenge of an Unresolved Issue

Romagnoli¹,

Fiacco²,

Russo³

et al. 2011

J Rheumatol

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Section: Rheumatologysupporting

confidence: 92%

Secondary Osteoporosis in Men and Women: Clinical Challenge of an Unresolved Issue

Romagnoli¹,

Fiacco²,

Russo³

et al. 2011

J Rheumatol

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“…Another result of our study shows that lumbar and femoral bone loss was more pronounced in patients with PHPT. According to other studies bone mineral densitometry is decreased in hyperparathyroidism, and after parathyroidectomy bone mineral densitometry improves [21]. …”

Section: Discussionmentioning

confidence: 99%

The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss

Yorulmaz

Akalın²,

Akay³

et al. 2016

Tjh

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Objective:Coagulation and fibrinolysis defects were reported in primary hyperparathyroid patients. However, there are not enough data regarding platelet functions in this group of patients. Our aim was to evaluate the platelet functions in primary and secondary hyperparathyroid patients and to compare them with healthy subjects.Materials and Methods:In our study 25 subjects with primary hyperparathyroidism (PHPT), 25 subjects with secondary hyperparathyroidism (SHPT), and 25 healthy controls were included. Platelet functions of the subjects were evaluated by using platelet-rich plasma and platelet aggregation tests induced with epinephrine, adenosine diphosphate (ADP), collagen, and ristocetin. Serum P selectin levels, which indicate platelet activation level, were measured in all subjects. Bone mineral densitometry was performed for all patients.Results:There was no significant difference between the groups with PHPT and SHPT and the control group regarding the platelet aggregation tests and serum P selectin levels. There was also no significant correlation between parathormone levels and aggregation parameters (ristocetin, epinephrine, collagen, and ADP: respectively p=0.446, 0.537, 0.346, and 0.302) and between P selectin (p=0.516) levels. When we separated the patients according to serum calcium levels, there was also no significant difference between aggregation parameters and serum P selectin levels between the patients with hypercalcemia and the patients with normocalcemia. We could not find any significant correlation between aggregation parameters, P selectin levels, and serum calcium levels in this group of patients. Bone loss was greater in patients with PHPT.Conclusion:There is no significant effect of PHPT or SHPT and serum calcium levels on platelet functions when evaluated by aggregation tests.

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“…But the same applies to parathyroidectomy, which also fails to achieve higher DEXA scores in many cases: In a study with post-menopausal women with pHPT the score had remained unchanged or even decreased one year after surgery in 52 out of 103 patients [7]. …”

Section: Parathyroidectomymentioning

confidence: 99%

Cinacalcet Treatment of Primary Hyperparathyroidism

Rothe

Liangos

Biggar

et al. 2011

International Journal of Endocrinology

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Although parathyroidectomy remains the only curative approach to most primary hyperparathyroidism cases, medical treatment with cinacalcet HCl has been proven to be a reasonable alternative for several patient subgroups. Cinacalcet almost always controls hypercalcemia and hypophosphatemia sufficiently. PTH levels are lowered, and cognitive parameters improve. While an increase in bone mineral density DEXA scan scores was not demonstrated in cinacalcet trials, the same applies to more than half of patients after parathyroidectomy. Medical therapy should be first choice in patients with hyperplasia in all glands rather than an isolated adenoma (10–15%), patients with persisting HPT following unsuccessful surgery or inoperable cases due to comorbidities, and patients detected in lab screens for hypercalcemia before developing symptoms who should be treated early but are usually reluctant to undergo surgery. Nephrolithiasis was not found to occur more frequently in cinacalcet trial groups, but urine calcium excretion as one major risk factor of this complication of primary HPT may increase on cinacalcet. Patients carrying the rs1042636 polymorphism of the calcium-sensing receptor gene respond more sensitively to cinacalcet and have a higher risk of calcium stone formation. Cinacalcet is usually administered twice daily but three or four doses per day should be discussed to mimic the beneficial pulsatile PTH-pattern.

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Effect of parathyroidectomy for primary hyperparathyroidism on bone mineral density in postmenopausal women

Cited by 34 publications

References 24 publications

Secondary Osteoporosis in Men and Women: Clinical Challenge of an Unresolved Issue

Secondary Osteoporosis in Men and Women: Clinical Challenge of an Unresolved Issue

The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss

Cinacalcet Treatment of Primary Hyperparathyroidism

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