The risk of fractures in postmenopausal women with primary hyperparathyroidism.
OBJECTIVE
To evaluate the prevalence of vertebral (vFr) and non-vertebral (nvFr) fractures in postmenopausal women with primary hyperparathyroidism (PHPT).


METHODS
We studied 98 patients with PHPT, divided into 'mild' (M, n = 25) and 'non-mild' (NM, n = 73) sub-groups, according to recently published guidelines (2002), and 89 healthy women (C) matched for age, years since menopause and body mass index. vFr was evaluated according to a visual semiquantitative method; bone mineral density (BMD) at the lumbar spine (LS), and femoral sites (femoral neck, FN and total femur, FT) was measured by dual energy X-ray absorptiometry. Volumetric BMD of the third lumbar vertebra (vBMDL3) was also calculated.


RESULTS
The prevalence of vFr was significantly higher (P < 0.001) in both M and NM PHPT patients compared with C; this prevalence did not differ between M and NM patients. BMD was significantly lower (P < 0.05) in NM patients compared with both C and M patients. BMD at LS in M patients was also significantly higher with respect to C. Similar results were also obtained for vBMDL3; in M patients, vBMDL3 was also significantly higher compared to C. When M and NM patients were subdivided according to the presence or lack of vFr, no difference was found between fractured and unfractured patients for either BMD or vBMDL3 values.


CONCLUSIONS
The risk of vFr is higher in postmenopausal patients with mild PHPT even if BMD appears well preserved. This finding suggests that other factors, such as bone quality, seem to be relevant in determining fracture risk, especially when gonadal function is lacking.
De Geronimo
Simona
S
Department of Clinical Sciences, University of Rome La Sapienza, Viale del Policlinico 155, 00161 Rome, Italy.
Romagnoli
Elisabetta
E
Diacinti
Daniele
D
D'Erasmo
Emilio
E
Minisola
Salvatore
S
D000368:Aged; D000886:Anthropometry; D001774:Blood Chemical Analysis; D015992:Body Mass Index; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology*; D018570:Risk Assessment