The risk of fractures in postmenopausal women with primary hyperparathyroidism
Open Access
- 1 September 2006
- journal article
- Published by Oxford University Press (OUP) in Acta Endocrinologica
- Vol. 155 (3), 415-420
- https://doi.org/10.1530/eje.1.02225
Abstract
Objective: To evaluate the prevalence of vertebral (vFr) and non-vertebral (nvFr) fractures in postmenopausal women with primary hyperparathyroidism (PHPT). Materials and Methods: We studied 98 patients with PHPT, divided into ‘mild’ (M, n = 25) and ‘non-mild’ (NM, n = 73) sub-groups, according to recently published guidelines (2002), and 89 healthy women (C) matched for age, years since menopause and body mass index. vFr was evaluated according to a visual semiquantitative method; bone mineral density (BMD) at the lumbar spine (LS), and femoral sites (femoral neck, FN and total femur, FT) was measured by dual energy X-ray absorptiometry. Volumetric BMD of the third lumbar vertebra (vBMDL3) was also calculated. Results: The prevalence of vFr was significantly higher (P < 0.001) in both M and NM PHPT patients compared with C; this prevalence did not differ between M and NM patients. BMD was significantly lower (P < 0.05) in NM patients compared with both C and M patients. BMD at LS in M patients was also significantly higher with respect to C. Similar results were also obtained for vBMDL3; in M patients, vBMDL3 was also significantly higher compared to C. When M and NM patients were subdivided according to the presence or lack of vFr, no difference was found between fractured and unfractured patients for either BMD or vBMDL3 values. Conclusions: The risk of vFr is higher in postmenopausal patients with mild PHPT even if BMD appears well preserved. This finding suggests that other factors, such as bone quality, seem to be relevant in determining fracture risk, especially when gonadal function is lacking.Keywords
This publication has 21 references indexed in Scilit:
- Primary hyperparathyroidism: new concepts in clinical, densitometric and biochemical featuresJournal of Internal Medicine, 2004
- Primary hyperparathyroidism and osteoporosis in 2004Joint Bone Spine, 2004
- The Anabolic Effects of Parathyroid HormoneOsteoporosis International, 2002
- Primary Hyperparathyroidism and the Risk of Fracture: A Population-Based StudyJournal of Bone and Mineral Research, 1999
- On the Mechanism of Cancellous Bone Preservation in Postmenopausal Women with Mild Primary HyperparathyroidismJournal of Clinical Endocrinology & Metabolism, 1999
- Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fracturesThe Lancet, 1996
- Fracture incidence in postmenopausal women with primary hyperparathyroidismSurgery, 1995
- The risk of hip fractures in patients with primary hyperparathyroidism: a population‐based cohort study with a follow‐up of 19 yearsJournal of Internal Medicine, 1993
- Skeletal disease in primary hyperparathyroidismJournal of Bone and Mineral Research, 1989
- Mild Asymptomatic Primary Hyperparathyroidism Is Not a Risk Factor for Vertebral FracturesAnnals of Internal Medicine, 1988