title: Factors associated with vertebral fracture risk in patients with primary hyperparathyroidism.
abstract: OBJECTIVE
  To examine factors, in addition to bone mineral density (BMD), such as the common calcium-sensing receptor (CASR) gene polymorphisms, associated with vertebral fracture (VFx) risk in primary hyperparathyroidism (PHPT).
  
  
  METHODS
  A cross-sectional analysis of 266 Caucasian PHPT seen as outpatients. Serum calcium (sCa) phosphate metabolism parameters were measured. BMD was assessed by dual-energy X-ray absorptiometry (expressed as Z-score) at lumbar spine (Z-LS) and femoral neck, morphometric VFx by radiograph, and CASR A986S/R990G genotypes by PCR amplification and genomic DNA sequencing.
  
  
  RESULTS
  Fractured patients (n=100, 37.6%) had lower sCa (10.8±0.7 mg/dl) and Z-LS BMD (-1.0±1.44), higher age (61±10 years), and prevalence (51%) of ≥1 S alleles of the CASR A986S single-nucleotide polymorphism (SNP; AS/SS), than those not fractured (n=166, 11.2±1.0 mg/dl, -0.57±0.97, 58±13 years, and 38% AS/SS, respectively, P<0.05 for all comparisons). Logistic regression, with VFx as dependent variable, showed independent risks associated with increased age (OR 1.03, 95% CI 1.01-1.06, P=0.006), decreased sCa (OR 1.86, 95% CI 1.28-2.7, P=0.001), and Z-LS BMD (OR 1.4, 95% CI 1.12-1.7, P=0.002) and presence of AS/SS (OR 1.8, 95% CI 1.1-2.9, P=0.05). The presence of two out of three factors (age ≥58 years, sCa <10.8 and Z-LS BMD≤-1.0, and AS/SS genotype) gave an overall OR of 4.2 (95% CI 2.25-7.85, P<0.0001).
  
  
  CONCLUSIONS
  In PHPT, VFx is associated positively with age, negatively with sCa and spinal BMD, and presence of at least one copy of the CASR A986S SNP.
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Cristina
authors: C
authors: Eller-Vainicher
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Claudia
authors: C
authors: Battista
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Vito
authors: V
authors: Guarnieri
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, CanadaUnit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Silvana
authors: S
authors: Muscarella
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Serena
authors: S
authors: Palmieri
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Antonio Stefano
authors: AS
authors: Salcuni
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Giuseppe
authors: G
authors: Guglielmi
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Sabrina
authors: S
authors: Corbetta
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Salvatore
authors: S
authors: Minisola
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Anna
authors: A
authors: Spada
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Geoffrey N
authors: GN
authors: Hendy
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: David E C
authors: DE
authors: Cole
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada iacopo.chiodini@unimi.it.
authors: Iacopo
authors: I
authors: Chiodini
authors: Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Padiglione Granelli, Via Francesco Sforza 35, 20122 Milan, ItalyUnit of Endocrinology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Radiology'Fatebenefratelli and Oftalmico' Hospital, Milan, ItalyUnit of Radiology'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, Foggia, ItalyUnit of Endocrinology and DiabetologyDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese, Milan, ItalyDepartment of Internal Medicine and Medical Disciplines'Sapienza' Rome University, Rome, ItalyDepartments of MedicinePhysiology, and Human Genetics, McGill University, Montreal, Quebec, CanadaDepartments of Laboratory Medicine and PathobiologyMedicine and Genetics, University of Toronto, Toronto, Ontario, Canada.
authors: Alfredo
authors: A
authors: Scillitani
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000000981:diagnostic imaging* / Q000652:urine; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D016103:Spinal Fractures / Q000097:blood / Q000000981:diagnostic imaging* / Q000652:urine; D055815:Young Adult