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The effect of parathyroidectomy on bone mineral density in primary hyperparathyroidism

Çalişkan MBeysel SKizilgül MÖzbek MÇakal E.

Turk J Med Sci. 2019 Oct 27. doi: 10.3906/sag-1904-49. [Epub ahead of print]

 

Abstract

BACKGROUND AND AIM:

This study aimed to investigate the change in bone mineral density (BMD) before and 1 year after parathyroidectomy in patients with primary hyperparathyroidism (PHPT).

MATERIALS AND METHODS:

The clinical and biochemical parameters and DEXA screening of patients with symptomatic PHPT (n=28) and asymptomatic PHPT (n=63) were investigated before and 1 year after parathyroidectomy.

RESULTS:

Patients with symptomatic PHPT had a higher prevalence of nephrolithiasis (18.2 vs. 4.6%, p=0.032) when compared to prevalence in patients with asymptomatic PHPT. The prevalence of osteoporosis in the lumbar spine (63.0 vs. 37.5%, p=0.026) and femoral neck (40.7 vs. 20.6%, p=0.048) was higher in symptomatic PHPT when compared to prevalence in asymptomatic PHPT. After parathyroidectomy, decrease in the prevalence of osteoporosis in lumbar spine (25.8 vs. 9.4%, p=0.014) and femoral neck (22.1 vs. 8.2%, p=0.009) and total hip (22.4 vs. 5.3%, p=0.007) were higher in symptomatic PHPT compared to asymptomatic PHPT group. A higher BMD gain (g/cm2) was seen in lumbar spine (10.83 vs. 4.65%, p=0.016) and femoral neck (12.61 vs. 4.37%, p=0.005) in symptomatic PHPT compared to asymptomatic PHPT group.

CONCLUSION:

Parathyroidectomy provided more BMD gain in the lumbar spine and femoral neck in patients with symptomatic PHPT when compared to patients with asymptomatic PHPT 1-year after parathyroidectomy.