Does homocysteine contribute to bone disease in hyperparathyroidism?
BACKGROUND
Osteoporosis is a complication of hyperparathyroidism (HPT). Hyperhomocysteinemia (HHCy) is an independent risk factor for osteoporotic fractures. We hypothesize that HHCy correlates with bone disease in HPT.


METHODS
A prospectively collected database of 250 patients treated for HPT was reviewed. Patients were categorized into 3 groups: group I, normal renal function; group 2, mild renal insufficiency; and group 3, secondary HPT with end-stage renal disease on dialysis. Serum homocysteine levels, markers of bone metabolism, and bone density studies were examined.


RESULTS
The prevalence of HHCy in group 1 (208 patients) was 5%, in group 2 (23 patients), 82%, and in group 3 (19 patients), 78%. Mean (+/-SD) preoperative homocysteinemia (HCy) levels in groups 1, 2, and 3 were 9.3 +/- 4.0, 20 +/- 10.2, and 20.6 +/- 12.3 micromol/L, respectively. Elevated serum markers of bone metabolism increased significantly with decreasing renal function.


CONCLUSIONS
Prevalence of HHCy is low in HPT patients with normal renal function. It is significantly greater in those with dialysis-independent and -dependent renal insufficiency. HHCy correlates with other serum markers of bone metabolism in HPT and may be useful for monitoring progression or improvement.
Alley
Robin A
RA
Department of General Surgery, Rush University Medical Center, 1653 W. Congress Pkwy., Chicago, IL 60612, USA.
Chen
Emery L
EL
Beyer
Todd D
TD
Prinz
Richard A
RA
D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D006961:Hyperparathyroidism / Q000150:complications* / Q000601:surgery; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000209:etiology*; D016105:Parathyroidectomy; D011446:Prospective Studies
D015415:Biomarkers; D006710:Homocysteine