title: Primary hyperparathyroidism: biochemical markers and bone mineral density at multiple skeletal sites in Danish patients.
abstract: Biochemical bone markers and bone mineral density (BMD) in spine, hip, and forearm were measured, before surgery, in 30 patients with mild to moderate primary hyperparathyroidism (PHP) (25 women and 5 men; mean age 54 +/- 12 years, range 26-73 years) and compared with normal controls. A group of 291 healthy adults (181 women and 110 men) served as controls for BMD. A smaller group of 30 normal individuals (25 women and 5 men; mean age 54 +/- 12 years; range 26-74 years) were used as matched normal controls. Parameters of bone formation (s-osteocalcin, s-alkaline phosphatase activity, and s-bone isoenzyme alkaline phosphatase activity) and bone resorption (s-type-1 collagen telopeptide) were considerably increased in patients with PHP compared with normal controls (p < 0.01 for all parameters). BMD was found to be reduced in the hip (trochanteric: 95.1 +/- 14.7% of expected, p < 0.05; intertrochanteric: 95.2 +/- 13.8% of expected, p < 0.05), and the forearm (proximal: 93.3 +/- 12.2% of expected, p < 0.05; mid: 91.8 +/- 11.6% of expected, p < 0.001; distal: 90.7 +/- 13.1% of expected, p < 0.001). Spine BMD was found significantly reduced in premenopausal (87.8 +/- 7.6% of expected, p < 0.05) but not in postmenopausal patients, and although normal women showed a decrease in spinal BMD with increasing age this was not found in the PHP women. Forearm BMD was reduced in both pre- and postmenopausal patients (distal forearm: 86.7 +/- 12.2% of expected, p < 0.05; 87.6 +/- 12.1% of expected, p < 0.01, respectively). It was concluded that Danish patients with mild or moderate PHP have only small reductions in BMD. The bone loss is mainly found in the appendicular skeleton.
authors.affiliation: University Department of Surgery, Aarhus Amtssygehus, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Christiansen
authors.forename: T
authors.initials: T
authors.lastname: Steiniche
authors.forename: K
authors.initials: K
authors.lastname: Brixen
authors.forename: I
authors.initials: I
authors.lastname: Hessov
authors.forename: F
authors.initials: F
authors.lastname: Melsen
authors.forename: P
authors.initials: P
authors.lastname: Charles
authors.forename: L
authors.initials: L
authors.lastname: Mosekilde
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood / Q000378:metabolism; D015415:Biomarkers / Q000097:blood*; D015519:Bone Density / Q000502:physiology*; D001846:Bone Development / Q000502:physiology; D001862:Bone Resorption / Q000097:blood / Q000652:urine; D015331:Cohort Studies; D003094:Collagen / Q000378:metabolism; D024042:Collagen Type I; D003718:Denmark; D005260:Female; D005269:Femur / Q000378:metabolism / Q000502:physiology; D005542:Forearm / Q000502:physiology; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D007527:Isoenzymes / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000378:metabolism; D011347:Procollagen / Q000097:blood; D013131:Spine / Q000378:metabolism / Q000502:physiology
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D007527:Isoenzymes; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin; D003094:Collagen; D000469:Alkaline Phosphatase