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Multifactorial risk profile for bone fractures in primary hyperparathyroidism

Nordenstrom, E; Westerdahl, Johan LU ; Lindergård, Birger LU ; Lindblom, Pia LU and Bergenfelz, Anders LU (2002) In World Journal of Surgery 26(12). p.1463-1467
Abstract
Primary hyperparathyroidism (pHPT) is associated with an increased fracture risk, and decreased bone density thus has been considered an indication for surgery. However, many pHPT patients have a multifactorial risk profile for osteoporosis and bone fractures. The aim of the present study was to evaluate variables associated with fracture risk within the group of pHPT patients. A series of 203 consecutive patients operated for pHPT were investigated with bone mineral content and biochemical and clinical risk factors for bone fracture. Seventeen patients (8%) had a history of at least one bone fracture up to 5 years before pHPT surgery. Twenty-six patients (13%) had a history of at least one fracture during the 10-year period prior to... (More)
Primary hyperparathyroidism (pHPT) is associated with an increased fracture risk, and decreased bone density thus has been considered an indication for surgery. However, many pHPT patients have a multifactorial risk profile for osteoporosis and bone fractures. The aim of the present study was to evaluate variables associated with fracture risk within the group of pHPT patients. A series of 203 consecutive patients operated for pHPT were investigated with bone mineral content and biochemical and clinical risk factors for bone fracture. Seventeen patients (8%) had a history of at least one bone fracture up to 5 years before pHPT surgery. Twenty-six patients (13%) had a history of at least one fracture during the 10-year period prior to surgery. In the univariate analyses corticosteroid treatment, serum levels of alkaline phosphatase, 25-hydroxyvitamin D-3, type I collagen telopeptide, and bone mineral content were found to be associated with a history of bone fractures up to 10 years before surgery. Additionally, age and menopausal status were of importance for fractures during the 10-year-period, whereas a history of cardiovascular disease was important for fractures during the 5-year-period prior to surgery. Multivariate analyses showed that serum level of PTH was independently associated with bone fractures during the 5-year period prior to pHPT surgery and further that serum level of 25-hydroxyvitainin D-3 was associated with fractures up to 10 years before surgery. In conclusion, serum levels of 25-hydroxyvitamin D-3 and PTH were independently associated with a history of bone fractures in pHPT. These variables should be considered when evaluating patients for parathyroid surgery. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
World Journal of Surgery
volume
26
issue
12
pages
1463 - 1467
publisher
Springer
external identifiers
  • pmid:12297914
  • wos:000179865400012
  • scopus:0036886030
ISSN
1432-2323
DOI
10.1007/s00268-002-6433-2
language
English
LU publication?
yes
id
597728dc-9218-4e73-adf0-740e473ffa7f (old id 321184)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12297914&dopt=Abstract
date added to LUP
2007-11-02 13:33:34
date last changed
2017-10-22 04:44:03
@article{597728dc-9218-4e73-adf0-740e473ffa7f,
  abstract     = {Primary hyperparathyroidism (pHPT) is associated with an increased fracture risk, and decreased bone density thus has been considered an indication for surgery. However, many pHPT patients have a multifactorial risk profile for osteoporosis and bone fractures. The aim of the present study was to evaluate variables associated with fracture risk within the group of pHPT patients. A series of 203 consecutive patients operated for pHPT were investigated with bone mineral content and biochemical and clinical risk factors for bone fracture. Seventeen patients (8%) had a history of at least one bone fracture up to 5 years before pHPT surgery. Twenty-six patients (13%) had a history of at least one fracture during the 10-year period prior to surgery. In the univariate analyses corticosteroid treatment, serum levels of alkaline phosphatase, 25-hydroxyvitamin D-3, type I collagen telopeptide, and bone mineral content were found to be associated with a history of bone fractures up to 10 years before surgery. Additionally, age and menopausal status were of importance for fractures during the 10-year-period, whereas a history of cardiovascular disease was important for fractures during the 5-year-period prior to surgery. Multivariate analyses showed that serum level of PTH was independently associated with bone fractures during the 5-year period prior to pHPT surgery and further that serum level of 25-hydroxyvitainin D-3 was associated with fractures up to 10 years before surgery. In conclusion, serum levels of 25-hydroxyvitamin D-3 and PTH were independently associated with a history of bone fractures in pHPT. These variables should be considered when evaluating patients for parathyroid surgery.},
  author       = {Nordenstrom, E and Westerdahl, Johan and Lindergård, Birger and Lindblom, Pia and Bergenfelz, Anders},
  issn         = {1432-2323},
  language     = {eng},
  number       = {12},
  pages        = {1463--1467},
  publisher    = {Springer},
  series       = {World Journal of Surgery},
  title        = {Multifactorial risk profile for bone fractures in primary hyperparathyroidism},
  url          = {http://dx.doi.org/10.1007/s00268-002-6433-2},
  volume       = {26},
  year         = {2002},
}