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

Almqvist, Erik LU ; Becker, Charlotte LU ; Bondeson, Anne-Greth LU ; Bondeson, Lennart LU and Svensson, J (2004) In Surgery 136(6). p.1281-1287
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Surgery
volume
136
issue
6
pages
1281 - 1287
publisher
Elsevier
external identifiers
  • pmid:15657588
  • wos:000225874800050
  • scopus:10644263741
ISSN
1532-7361
DOI
10.1016/j.surg.2004.06.059
language
English
LU publication?
yes
id
eee6632b-efc5-4e68-a72d-94826751c78e (old id 897718)
date added to LUP
2008-01-10 10:30:21
date last changed
2017-09-17 07:52:53
@article{eee6632b-efc5-4e68-a72d-94826751c78e,
  abstract     = {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 &lt;.0001) and increased lumbar spine BAW (P &lt;.05) equally in both groups, even in patients without overt osteoporosis, whereas hip BAM was increased (P &lt;.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.},
  author       = {Almqvist, Erik and Becker, Charlotte and Bondeson, Anne-Greth and Bondeson, Lennart and Svensson, J},
  issn         = {1532-7361},
  language     = {eng},
  number       = {6},
  pages        = {1281--1287},
  publisher    = {Elsevier},
  series       = {Surgery},
  title        = {Early parathyroidectomy increases bone mineral density in patients with mild primary hyperparathyroidism: A prospective and randomized study},
  url          = {http://dx.doi.org/10.1016/j.surg.2004.06.059},
  volume       = {136},
  year         = {2004},
}