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Bone mineral density analysis in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1 after total parathyroidectomy
Author(s) -
Coutinho Flavia L.,
Lourenço Jr Delmar M.,
Toledo Rodrigo A.,
Montenegro Fabio L. M.,
CorreiaDeur Joya E. M.,
Toledo Sergio P. A.
Publication year - 2010
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2009.03672.x
Subject(s) - men1 , bone mineral , multiple endocrine neoplasia , medicine , parathyroidectomy , primary hyperparathyroidism , hyperparathyroidism , urology , endocrinology , femoral neck , gastroenterology , endocrine system , parathyroid hormone , osteoporosis , chemistry , hormone , calcium , biochemistry , gene
Summary Objective Limited data have been reported on the effect of parathyroidectomy (PTx) on bone mineral density (BMD) in the setting of patients with hyperparathyroidism (HPT) associated with multiple endocrine neoplasia type 1 (MEN1). This study investigates the impact of total PTx on BMD in patients with HPT/MEN1. Design and patients A case series study was performed in a tertiary academic hospital. A total of 16 HPT/MEN1 patients from six families harbouring MEN1 germline mutations were subjected to total PTx followed by parathyroid auto‐implant in the forearm. Measurements Bone mineral density values were assessed using dual‐energy X‐ray absorptiometry. Results Before PTx, reduced BMD ( Z ‐score <−2·0) was highly prevalent in the proximal one‐third of the distal radius (1/3 DR) (50%), lumbar spine (LS) (43·7%), ultradistal radius (UDR) (43·7%), femoral neck (FN) (25%) and total femur (TF) (18·7%) in the patients. Fifteen months after PTx, we observed a BMD improvement in the LS (from 0·843 to 0·909 g/cm 2 ; +8·4%, P = 0·001), FN (from 0·745 to 0·798 g/cm 2 ; +7·7%, P = 0·0001) and TF (from 0·818 to 0·874 g/cm 2 ; +6·9%, P < 0·0001). No significant change was noticed in the 1/3 DR and UDR after PTx. Conclusions This data confirmed BMD recovery in the LS and FN after PTx in HPT/MEN1 patients. We also documented a significant BMD increase in the TF and no change in both the 1/3 DR and UDR BMD after PTx. Our data suggest that LS and proximal femur are the most informative sites to evaluate the short‐term BMD outcome after PTx in HPT/MEN1 subjects.