Bone status in primary hyperparathyroidism assessed by regional bone mineral density from the whole body scan and QUS imaging at calcaneus.
To assess the bone mineral density status in primary hyperparathyroidism (PHPT), we studied 64 females with PHPT and 17 healthy women. Regional BMD (arms, trunk, legs) from the whole body scan and conventional sites (lumbar spine, femur, radius) were assessed by DXA. Quantitative ultrasound (QUS) imaging measurements were performed at calcaneus. Sixteen women had history of renal lithiasis, 11 had low impact fracture and 37 women had neither renal lithiasis nor fracture. In the entire group, the mean Z-scores were significantly decreased at all sites (lumbar spine, femur, radius). In all clinical subgroups, the mean Z-scores were significantly decreased at radius. The mean Z-scores in premenopausal women were significantly decreased comparatively to postmenopausal women at lumbar spine and femur. In a group of PHPT females matched to controls for age and BMI, only BMD values at radius were lower in PHPT patients than in control (P < 0.03). However, from the whole body scan data, all sites but no trunk were significantly involved in PHPT patients (P < 0.04). Using QUS measurements at calcaneus, the BUA but not SOS in PHPT females was significantly lower (P = 0.03) than in controls. Our results suggest that low BMD at lumbar spine and femur is encountered preferentially in premenopausal women. The BMD decrease predominates at limbs in PHPT with presumably a gradient from proximal to distal part of the limbs. Indeed, the distal part of the limbs are the most affected areas in PHPT whatever the amount of cortical or trabecular bone.
Chappard
Christine
C
Service de Physiologie et Radio-isotopes, Hôpital Européen Georges Pompidou, Paris, France. christine.chappard@chr-orleans.fr
Roux
Christian
C
Laugier
Pascal
P
Paillard
Michel
M
Houillier
Pascal
P
D015502:Absorptiometry, Photon; D001132:Arm / Q000000981:diagnostic imaging; D015415:Biomarkers; D015519:Bone Density / Q000502:physiology*; D002111:Calcaneus / Q000000981:diagnostic imaging*; D002118:Calcium / Q000097:blood; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010384:Pelvic Bones / Q000000981:diagnostic imaging; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D011863:Radioimmunoassay; D012272:Ribs / Q000000981:diagnostic imaging; D012720:Severity of Illness Index; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D051598:Whole Body Imaging / Q000379:methods*
D015415:Biomarkers; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; C104450:25-hydroxyvitamin D; D002118:Calcium