title: Peripheral bone mineral density in correlation to disease-related predisposing conditions in patients with multiple endocrine neoplasia type 1.
abstract: OBJECTIVE
  Patients with multiple endocrine neoplasia type 1 (MEN1) often have low bone mineral density (BMD) attributed to primary hyperparathyroidism (pHPT). However, in MEN1 patients, other endocrine dysfunctions and conditions such as hypercortisolism, hypogonadism, and GH deficiency due to pituitary manifestation, and surgery on the upper gastrointestinal tract may affect BMD.
  
  
  METHODS
  In 23 patients with MEN1 (10 females, 13 males; 46±12 yr), BMD was determined by quantitative computed tomography at the forearm (pqCT), compared to a reference population and related to different conditions suspected to affect bone metabolism in MEN1.
  
  
  RESULTS
  In this cohort, Z-score for trabecular BMD was -0.85±1.18 and for total BMD -1.16±1.04. There was a similar trend towards lower BMD in uncontrolled hyperparathyroidism, hypercortisolism, hypogonadism/GH deficiency and the state after surgery at the upper gastrointestinal tract.
  
  
  CONCLUSIONS
  These data while confirming previous observations on reduced BMD in patients with MEN1, however, challenge its only or even predominant association with pHPT. Other conditions such as hypercortisolism, somatotrophic/ gonadotrophic pituitary insufficiency, and previous upper gastrointestinal surgery seem to be factors contributing to the risk of developing osteoporosis.
authors.affiliation: Division of Endocrinology and Diabetology, Faculty of Medicine and University Hospital, Philipp's University, Marburg, Germany. kannp@med.uni-marburg.de
authors.forename: P H
authors.initials: PH
authors.lastname: Kann
authors.forename: D
authors.initials: D
authors.lastname: Bartsch
authors.forename: P
authors.initials: P
authors.lastname: Langer
authors.forename: J
authors.initials: J
authors.lastname: Waldmann
authors.forename: P
authors.initials: P
authors.lastname: Hadji
authors.forename: A
authors.initials: A
authors.lastname: Pfützner
authors.forename: J
authors.initials: J
authors.lastname: Klüsener
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000150:complications* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D055815:Young Adult