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Bone Mineral Density Improvement After Successful Parathyroidectomy in Pre‐ and Postmenopausal Women with Primary Hyperparathyroidism
Author(s) -
LUMACHI FRANCO,
CAMOZZI VALENTINA,
ERMANI MARIO,
DE LOTTO FEDERICA,
LUISETTO GIOVANNI
Publication year - 2007
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1402.012
Subject(s) - medicine , bone mineral , primary hyperparathyroidism , parathyroidectomy , urology , osteocalcin , osteoporosis , hyperparathyroidism , bone density , creatinine , gastroenterology , alkaline phosphatase , endocrinology , parathyroid hormone , calcium , chemistry , biochemistry , enzyme
: The aim of this study was to evaluate the short‐term (1 year) changes of the lumbar spine (L2–L4) bone mineral density (LS‐BMD) after parathyroidectomy (PTx) in pre‐ and postmenopausal women with primary hyperparathyroidism (PHPT). A series of 48 women (median age 56 years, range 23–82 years) with confirmed PHPT were prospectively enrolled in the study. Patients who received both oral contraceptives less than 2 years before the diagnosis and estrogen replacement therapy have previously been excluded. All patients underwent LS‐BMD by dual energy x‐ray absorptiometry before surgery. Patients were divided into two groups: group A ( n = 12) premenopausal, and group B ( n = 36) postmenopausal patients. The LS‐BMD was repeated 12 months after successful PTx. Basal LS‐BMD (0.852 ± 0.061 vs. 0.748 ± 0.142 g/cm 2 ), serum calcium (2.95 ± 0.23 vs. 2.94 ± 0.26 mmol/L), creatinine (69.2 ± 17.5 vs. 82.0 ± 24.2 μmol/L), alkaline phosphatase (107.4 ± 43.6 vs. 151.3 ± 95.7 U/L), osteocalcin (28.6 ± 9.3 vs. 28.2 ± 8.3 μg/L), and PTH (192.7 ± 133.2 vs. 175.2 ± 132.1 ng/L) levels did not differ significantly ( P = NS) between groups. The 1‐year LS‐BMD was 0.921 ± 0.048 and 0.825 ± 0.151 g/cm 2 in group A and B, respectively. In group B patients, the 1‐year LS‐BMD value did not improve significantly ( P = NS), while in group A patients the difference between basal and postsurgical LS‐BMD was significant ( P < 0.01). In conclusion, PTx should be considered for all patients with PHPT and loss of bone density, but in premenopausal patients a greatest improvement of BMD may be found, suggesting the need of endogenous estrogens in complete lumbar bone recovery after surgery.