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Early parathyroidectomy increases bone mineral density in patients with mild primary hyperparathyroidism: A prospective and randomized study

På svenska

Author

  • Erik Almqvist
  • Charlotte Becker
  • Anne-Greth Bondeson
  • Lennart Bondeson
  • J Svensson

Summary, in English

Background. There is an ongoing controversy regarding how to take care of patients with mild primary hyperparathyroidism (PHPT) and how to grade their disease activity in terms of bone parameters. This prospective and randomized study was undertaken to evaluate skeletal effects of delayed surgical treatment in such patients. Methods. Fifty patients with mild PHPT (serum calcium, 2.55 to 2.95 mmol/L, 10.2 to 11.8 mg/dL) were randomized to parathyroidectomy either at diagnosis or 1 year later. Hip and spine bone mineral density (BMD, determined by dual energy x-ray absorptiometry), bone alkaline phosphatase in serum, osteocalcin and P-CrossLaps in plasma, and calcium in urine were measured in all patients at inclusion in the study and 1 and 2 years later. Results. The skeletal effects of mild PHPT varied with anatomy and time of exposure. Parathyroidectomy decreased all biochemical bone markers (P <.0001) and increased lumbar spine BAW (P <.05) equally in both groups, even in patients without overt osteoporosis, whereas hip BAM was increased (P <.05) in the early intervention group only. Conclusion. Prolonged exposure to mild and seemingly stable PHPT is a risk factor for hip fractures, which adds to other reasons for surgical treatment of this condition without delay regardless of serum calcium levels.

Publishing year

2004

Language

English

Pages

1281-1287

Publication/Series

Surgery

Volume

136

Issue

6

Document type

Journal article

Publisher

Elsevier

Topic

  • Surgery

Status

Published

Research group

  • Surgery
  • Clinical Chemistry, Malmö
  • Pathology, Malmö

ISBN/ISSN/Other

  • ISSN: 1532-7361