The effect of parathyroidectomy on bone mineral density in primary hyperparathyroidism

doi:10.3906/sag-1904-49

Cited by 3 publications

(4 citation statements)

References 36 publications

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“…Although our study failed to find a correlation between β-CTx at baseline and BMD changes after RFA, ALP correlated negatively with BMD in both the lumbar spine and femoral neck. There was a decrease of BMD in the lumbar spine of patients with PHPT, which is consistent with other series studies on PTX ( 5 , 16 - 18 , 22 ). Another principal finding was that RFA was associated with an increase in the BMD to the level of that of the age-matched controls in the lumbar spine but not in the femoral neck.…”

Section: Discussionsupporting

confidence: 92%

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Changes in bone turnover markers and bone mineral density after radiofrequency ablation for mild primary hyperparathyroidism: a prospective cohort study

Han,

Xue,

Liang

et al. 2024

Quant Imaging Med Surg

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Background The application of radiofrequency ablation (RFA) is becoming increasingly widespread in the treatment of primary hyperparathyroidism (PHPT). However, the effect of RFA treatment on the skeleton in mild PHPT remains unclear. Therefore, the aim of this study was to investigate the change in bone turnover markers and bone mineral density (BMD) before and 2 years after RFA in patients with mild PHPT. Methods In this open-label, prospective study, 81 patients with mild PHPT including 36 treated with RFA and 45 observed without intervention (OBS), along with 81 age-matched healthy controls, were enrolled from November 2018 to September 2021 at Gansu Provincial Hospital. The main outcome measures were levels of serum calcium, serum intact parathyroid hormone (iPTH), and bone turnover markers, including bone-specific alkaline phosphatase (ALP), C-terminal cross-linking telopeptides of type I collagen (β-CTx), and osteocalcin (OC). BMD (femoral neck and lumbar spine) was measured with dual-energy X-ray absorptiometry, and spine radiographs were obtained for vertebral fracture assessment. Paired and unpaired two-tailed t -tests and Spearman rank correlation coefficient were used for statistical analyses. Results Normalized outcomes for both iPTH and calcium levels were achieved in 32 of 36 (88.9%) patients with mild PHPT treated with RFA. There was a significant treatment effect of RFA on bone turnover biomarkers compared with OBS before the treatment (P=0.04) and at the end of follow-up or (P=0.03). BMD of the lumbar spine increased by 1.8% (P=0.03) and remained stable in the femoral neck (P=0.17) after RFA. However, there was an obvious treatment effect of RFA on BMD compared with OBS (P 0.04). The only compartment with a T-score increase in the RFA group was the lumbar spine in (P<0.001). There was no difference in fracture frequency between groups during the follow-up period. Conclusions RFA can improve serum bone turnover markers in patients with mild PHPT and can be expected to increase BMD in the L1–L4 vertebrae and preserve BMD in the femoral neck. Whether RFA can reduce fracture risk in the long-term is a clinical concern for patients with mild PHPT.

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Section: Discussionsupporting

confidence: 92%

“…The beneficial effect of PTX on bone involvement has been demonstrated ( 16 - 20 ). In our cohort, as many as 81% of the cases had a low BMD at the lumbar spine or femoral neck compared with 29% of the matched controls, which suggests significant bone loss in patients with mild PHPT.…”

Section: Discussionmentioning

confidence: 99%

Changes in bone turnover markers and bone mineral density after radiofrequency ablation for mild primary hyperparathyroidism: a prospective cohort study

Han,

Xue,

Liang

et al. 2024

Quant Imaging Med Surg

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“…Long-term postoperative follow-up analysis of BMD in patients with hyperparathyroidism is limited in the literature. 13 The present study assessed patients with moderate to severe PHPT for 2 years following surgery. We observed that BMD of the total hip and lumbar spine was significantly improved after 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…Most previous studies focused on primary hyperthyroidism and did not distinguish patients with the severe form of this disease. 13 , 14 The present study performed a comprehensive analysis of patients with moderate to severe PHPT in our hospital. BMD measurements were performed using dual-energy X-ray absorptiometry (DXA) to analyze changes in BMD at different sites, including the lumbar spine and total hip, before parathyroidectomy, and 6 months, 1 year, and 2 years after parathyroidectomy.…”

Section: Introductionmentioning

confidence: 99%

Changes in bone mineral density after parathyroidectomy in patients with moderate to severe primary hyperparathyroidism

et al. 2020

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Objective Primary hyperparathyroidism (PHPT) is relatively common in China and results in severe damage to the skeletal system. This study aimed to investigate changes in bone mineral density (BMD) over 2 years in patients with PHPT after parathyroidectomy. Methods This retrospective cohort study included patients with PHPT who underwent parathyroidectomy between January 2010 and December 2015. BMD and T-scores and Z-scores of the lumbar spine (L1, L2, L3, and L4) and total hip (femoral neck, great trochanter, and Ward’s triangle) at baseline and 2 years after surgery were measured by dual-energy X-ray absorptiometry. Results Thirty patients with moderate to severe PHPT (17 men and 13 women) aged 38.90±15.48 years were included. BMD, and T-score and Z-score values at the lumbar spine and total hip at 6 months, 1 year, and 2 years after parathyroidectomy were significantly improved compared with preoperative values. Improvement in BMD was largest at L4 (46.7%) and smallest at L1 (37.4%) in the lumbar spine 2 years after parathyroidectomy. For the total hip, the increase in BMD was largest at Ward’s triangle (42.6%) and smallest at the femoral neck (37.5%). Conclusions BMD of the lumbar spine and total hip is improved after parathyroidectomy in patients with PHPT.

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Symptomatic versus asymptomatic primary hyperparathyroidism: A systematic review and meta-analysis

Kulkarni¹,

Tucker²,

King³

et al. 2023

Journal of Clinical & Translational Endocrinology

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The effect of parathyroidectomy on bone mineral density in primary hyperparathyroidism

Cited by 3 publications

References 36 publications

Changes in bone turnover markers and bone mineral density after radiofrequency ablation for mild primary hyperparathyroidism: a prospective cohort study

Changes in bone turnover markers and bone mineral density after radiofrequency ablation for mild primary hyperparathyroidism: a prospective cohort study

Changes in bone mineral density after parathyroidectomy in patients with moderate to severe primary hyperparathyroidism

Symptomatic versus asymptomatic primary hyperparathyroidism: A systematic review and meta-analysis

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