Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025
Postparathyroidectomy Bone Density Changes in Patients With Biochemically Mild Primary Hyperparathyroidism.
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Kather Firdhous Abdul, Esfandiari Nazanene H, Clines Gregory A, Janney Carol A, Hughes David T, Saberi Sima
Аннотация
OBJECTIVE: Primary hyperparathyroidism significantly impacts bone health leading to decreased bone mineral density (BMD). We assessed changes in BMD following parathyroidectomy in patients with biochemically mild primary hyperparathyroidism.
METHODS: A retrospective chart review of 93 patients with primary hyperparathyroidism who underwent parathyroidectomy between 2000 and 2022 was conducted. Dual-energy x-ray absorptiometry (DXA) scans were done at the same site pre- and postparathyroidectomy at varying time points. Statistical analyses were performed using ANOVA as the homogeneity of variance was > 0.05. A P-value of <0.05 was considered statistically significant.
RESULTS: No statistically significant differences in DXA measurements were observed based on age, timing of DXA after parathyroidectomy, number and total weight of removed parathyroid glands, preoperative vitamin D levels, or preoperative 24-hour urinary calcium levels. In site-specific analysis based on T-scores at individual skeletal regions, only the femoral neck showed a significant postoperative BMD improvement in osteoporotic patients compared to those with osteopenia (P = .018) and normal bone density (P = .019), while the lumbar spine and total hip did not. When patients were grouped by overall osteoporosis status-defined as having osteoporosis at any site-significant BMD improvements were observed at the femoral neck and total hip compared to those with osteopenia (P = .031 and P = .015, respectively).
CONCLUSION: These findings underscore the potential for tailored interventions in managing bone health in patients with mild primary hyperparathyroidism, emphasizing the need for personalized approaches to optimize outcomes.
METHODS: A retrospective chart review of 93 patients with primary hyperparathyroidism who underwent parathyroidectomy between 2000 and 2022 was conducted. Dual-energy x-ray absorptiometry (DXA) scans were done at the same site pre- and postparathyroidectomy at varying time points. Statistical analyses were performed using ANOVA as the homogeneity of variance was > 0.05. A P-value of <0.05 was considered statistically significant.
RESULTS: No statistically significant differences in DXA measurements were observed based on age, timing of DXA after parathyroidectomy, number and total weight of removed parathyroid glands, preoperative vitamin D levels, or preoperative 24-hour urinary calcium levels. In site-specific analysis based on T-scores at individual skeletal regions, only the femoral neck showed a significant postoperative BMD improvement in osteoporotic patients compared to those with osteopenia (P = .018) and normal bone density (P = .019), while the lumbar spine and total hip did not. When patients were grouped by overall osteoporosis status-defined as having osteoporosis at any site-significant BMD improvements were observed at the femoral neck and total hip compared to those with osteopenia (P = .031 and P = .015, respectively).
CONCLUSION: These findings underscore the potential for tailored interventions in managing bone health in patients with mild primary hyperparathyroidism, emphasizing the need for personalized approaches to optimize outcomes.