title: Bone mineral density evolution after successful parathyroidectomy in patients with normocalcemic primary hyperparathyroidism.
abstract: BACKGROUND
  It is unclear whether bone mineral density (BMD) improves in patients with normocalcemic primary hyperparathyroidism (PHPT) after parathyroidectomy (PTX).
  
  
  OBJECTIVE
  The objective of the study was to evaluate and compare the impact of PTX on BMD change at 1 year in normocalcemic vs hypercalcemic PHPT.
  
  
  METHODS
  This was a longitudinal cohort study.
  
  
  METHODS
  The study took place at a referral center.
  
  
  METHODS
  We included 60 PHPT patients (mean age 64.0 ± 10.1 years), successfully treated by PTX by the same surgeon. Two groups were individualized according to baseline serum total (albumin corrected) calcium: 39 patients with normal baseline serum total calcium (normocalcemic group) and 21 patients with hypercalcemia at baseline (hypercalcemic group).
  
  
  METHODS
  BMD changes 1 year after PTX were measured.
  
  
  RESULTS
  In the normocalcemic group, BMD increased significantly by +2.3 ± 5.0% at the spine (P = .016) and +1.9 ± 5.7% at the hip (P = .048). In the hypercalcemic group, BMD increased significantly by +4.0 ± 3.8% at the spine (P = .0003) and +3.2 ± 4.2% at the hip (P = .003). There was no difference in these BMD gains between both groups (P > .1). The presence of multiple adenomas or hyperplasia was more frequent in the normocalcemic group than in the hypercalcemic group (P = .04).
  
  
  CONCLUSIONS
  Our results indicate for the first time that successful PTX in normocalcemic PHPT patients with osteoporosis is followed with mild but significant BMD improvement at the spine and hip at 1 year, comparable with that observed in hypercalcemic PHPT, suggesting that PTX may be beneficial in normocalcemic PHPT.
authors.affiliation: Department of Rheumatology A, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France.
authors.forename: Eugénie
authors.initials: E
authors.lastname: Koumakis
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: Emile
authors.initials: E
authors.lastname: Sarfati
authors.forename: Marine
authors.initials: M
authors.lastname: Meunier
authors.forename: Emilie
authors.initials: E
authors.lastname: Maury
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gallimard
authors.forename: Didier
authors.initials: D
authors.lastname: Borderie
authors.forename: André
authors.initials: A
authors.lastname: Kahan
authors.forename: Catherine
authors.initials: C
authors.lastname: Cormier
mesh_terms: D000368:Aged; D015519:Bone Density; D002118:Calcium / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000473:pathology / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium