1. Heath H 3rd, Hodgson SF, Kennedy MA. Primary hyperparathyroidism. Incidence, morbidity, and potential economic impact in a community. N Engl J Med. 1980 Jan 24;302(4):189-93.
2. Wermers RA, Khosla S, Atkinson EJ, Hodgson SF, O’Fallon WM, Melton LJ 3rd. The rise and fall of primary hyperparathyroidism: a population-based study in Rochester, Minnesota, 1965-1992. Ann Intern Med. 1997 Mar 15;126(6):433-40.
3. Lundgren E, Rastad J, Thrufjell E, Akerström G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997 Mar;121(3):287-94.
4. Mundy GR, Cove DH, Fisken R. Primary hyperparathyroidism: changes in the pattern of clinical presentation. Lancet. 1980 Jun 21;1(8182):1317-20.
5. Scholz DA, Purnell DC. Asymptomatic primary hyperparathyroidism. 10-year prospective study. Mayo Clin Proc. 1981 Aug;56(8):473-8.
6. Bilezikian JP, Silverberg SJ. Clinical presentation of primary hyperparathyroidism in the United States. In: Bilezikian JP, Levine MA, Marcus R, editors. The parathyroids: basic and clinical concepts. 2nd ed. San Diego: Academic Press; 2000. p. 349-60.
7. Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP. A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999 Oct 21;341(17):1249-55. Erratum in: N Engl J Med 2000 Jan 13;342(2):144.
8. Silverberg SJ, Shane E, de la Cruz L, Dempster DW, Feldman F, Seldin D, Jacobs TP, Siris ES, Cafferty M, Parisien MV, Lindsay R, Clemens TL, Bilezikian JP. Skeletal disease in primary hyperparathyroidism. J Bone Miner Res. 1989 Jun;4(3):283-91.
9. Silverberg SJ, Locker FG, Bilezikian JP. Vertebral osteopenia: a new indication for surgery in primary hyperparathyroidism. J Clin Endocrinol Metab. 1996 Nov;81(11):4007-12. [CrossRef]
10. Christiansen P, Steiniche T, Vesterby A, Mosekilde L, Hessov I, Melsen F. Primary hyperparathyroidism: iliac crest trabecular bone volume, structure, remodeling, and balance evaluated by histomorphometric methods. Bone. 1992;13(1):41-9. [CrossRef] [PubMed]
11. Khosla S, Melton LJ 3rd, Wermers RA, Crowson CS, O’Fallon W, Riggs B. Primary hyperparathyroidism and the risk of fracture: a population-based study. J Bone Miner Res. 1999 Oct;14(10):1700-7. [Web of Science] [CrossRef]
12. Rubin MR, Bilezikian JP, McMahon DJ, Jacobs T, Shane E, Siris E, Udesky J, Silverberg SJ. The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Clin Endocrinol Metab. 2008 Sep;93(9):3462-70. [CrossRef]
13. Rao DS, Wilson RJ, Kleerekoper M, Parfitt AM. Lack of biochemical progression or continuation of accelerated bone loss in mild asymptomatic primary hyperparathyroidism: evidence for biphasic disease course. J Clin Endocrinol Metab. 1988 Dec;67(6):1294-8. [CrossRef]
14. Guo CY, Thomas WE, al-Dehaimi AW, Assiri AM, Eastell R. Longitudinal changes in bone mineral density and bone turnover in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab. 1996 Oct;81(10):3487-91. [CrossRef]
15. Silverberg SJ, Gartenberg F, Jacobs TP, Shane E, Siris E, Staron RB, Bilezikian JP. Longitudinal measurements of bone density and biochemical indices in untreated primary hyperparathyroidism. J Clin Endocrinol Metab. 1995 Mar;80(3):723-8. [PubMed]
16. 2007 ISCD Official Positions [Internet]. Middletown (CT): International Society for Clinical Densitometry, Inc.; 2007 Oct 1 [updated 2011 May 4; cited 2011 May 30]. Available from: http://www.iscd.org/visitors/positions/OfficialPositionsText.cfm.
17. Parisien M, Silverberg SJ, Shane E, de la Cruz L, Lindsay R, Bilezikian JP, Dempster DW. The histomorphometry of bone in primary hyperparathyroidism: preservation of cancellous bone structure. J Clin Endocrinol Metab. 1990 Apr;70(4):930-8.
18. Dempster DW, Parisien M, Silverberg SJ, Liang XG, Schnitzer M, Shen V, Shane E, Kimmel DB, Recker R, Lindsay R, Bilezikian JP. On the mechanism of cancellous bone preservation in postmenopausal women with mild primary hyperparathyroidism. J Clin Endocrinol Metab. 1999 May;84(5):1562-6. [CrossRef]
19. Cope O. The study of hyperparathyroidism at the Massachusetts General Hospital. N Engl J Med. 1966 May 26;274(21):1174-82.
20. Bilezikian JP, Khan AA, Potts JT Jr; Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop. J Clin Endocrinol Metab. 2009 Feb;94(2):335-9. [PubMed]
Access brought to you by:
Volume 58 (2013)
Volume 57 (2012)
Volume 56 (2011)
Volume 55 (2010)
Volume 54 (2009)
Most Downloaded Articles
- Propofol vs isoflurane anesthesia-incidence of PONV in patients at maxillofacial surgery by Gecaj-Gashi, A/ Hashimi, M/ Sada, F/ Baftiu, N/ Salihu, S/ Terziqi, H and Bruqi, B
- Fetal membranes as a source of stem cells by Kmiecik, G./ Niklińska, W./ Kuć, P./ Pancewicz-Wojtkiewicz, J./ Fil, D./ Karwowska, A./ Karczewski, J. and Mackiewicz, Z.
- Optimizing biliary stent patency by coating with hydrophobin alone or hydrophobin and antibiotics or heparin: an in vitro proof of principle study by Weickert, U/ Wiesend, F/ Subkowski, T/ Eickhoff, A and Reiss, G
- Magnetic nanoparticles as new diagnostic tools in medicine by Niemirowicz, K/ Markiewicz, KH/ Wilczewska, AZ and Car, H
- Oxidative stress induced in rat liver by anticancer drugs doxorubicin, paclitaxel and docetaxel by Pieniążek, A/ Czepas, J/ Piasecka-Zelga, J/ Gwoździński, K and Koceva-Chyła, A
Prevalence of primary hyperparathyroidism among patients with low bone mass
1Endocrinology Department, Medical Centre for Postgraduate Education, Bielanski Hospital, Warsaw, Poland
This content is open access.
Citation Information: Advances in Medical Sciences. Volume 57, Issue 2, Pages 308–313, ISSN (Online) 1898-4002, ISSN (Print) 1896-1126, DOI: 10.2478/v10039-012-0062-2, January 2013
- Published Online:
Purpose: Accelerated rate of bone turnover and increased resorption due to primary hyperparathyroidism (PHPT) result in osteopenia and an increase in the fracture risk. However, there are no data about the relative frequency of the PHPT in the subpopulation with the low bone mass. The aim of the study was to evaluate the diagnostic power of the bone densitometry in diagnosis of PHPT.
Patients and Methods: Material consisted of 4016 new patients: 2504 women and 1512 men. Bone mineral density (BMD) in the L2 - L4 vertebra and femoral neck was measured by DEXA (LUNAR - DPX or LUNAR - EXPERT, Lunar Radiation Corp., USA). All the patients with BMD Z-score below -2.0 SD (according to the sex and age) were the subjects of further diagnostic procedures. The serum calcium and intact PTH level as well as 24-hours urine excretion was measured.
Results: In 451 (331 women and 120 men) out of the total 4016 patients, the measured BMD Z-scores were below -2.0 SD. Out of these 451 patients, 52 were diagnosed with PHPT. In 41 patients, diagnosis of PHPT was based on elevated serum intact PTH in the face of overt hypercalcemia. The remaining 11 normocalcemic patients with elevated PTH and coexisting vitamin D deficiency, will become hypercalcemic after vitamin D replacement.
Conclusions: In the large cohort of unselected patients who presented for bone densitometry, a very high (11.5%) prevalence of PHPT was found among subjects with low bone mass (BMD Z-score less than -2.0 SD). Presented results confirm the importance of the BMD measurements in the screening of the disease.