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Horm Metab Res 2006; 38(6): 411-416
DOI: 10.1055/s-2006-944533
Original Clinical
© Georg Thieme Verlag KG Stuttgart · New York

The Usefulness of Bone Metabolic Indices for the Prediction of Changes in Bone Mineral Density after Parathyroidectomy in Patients with Primary Hyperparathyroidism

H.  Kaji1 , R.  Nomura1 , M.  Yamauchi2 , K.  Chihara1 , T.  Sugimoto2
  • 1Division of Endocrinology/Metabolism, Neurology and Hematology/Oncology, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
  • 2Department of Endocrinology, Metabolism and Hematological Oncology, Shimane University School of Medicine, Shimane, Japan
Further Information

Publication History

Received 19 September 2005

Accepted after revision 2 January 2006

Publication Date:
06 July 2006 (online)

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Abstract

Patients with primary hyperparathyroidism (pHPT) have reduced bone mineral density (BMD). Although pHPT causes high bone turnover, the exact metabolic bone markers useful for predicting changes in BMD after parathyroidectomy (PTX) remain elusive. The present study was performed to examine the relationship between bone metabolic indices and BMD changes after PTX in 29 pHPT Japanese patients, which received PTX successfully. BMD values were measured by dual-energy X-ray absorptiometry in the lumbar spine and distal one third of radius. As for bone metabolic indices, serum bone-type alkaline phosphates (BAP), serum osteocalcin (OCN), urinary deoxypiridinoline (Dpd), and urinary type I collagen cross-linked N-telopeptides (NTX) were measured. The study included 10 male and 19 female patients (17 postmenopausal). Urinary Dpd, but not NTX was significantly correlated with serum BAP and OCN. Either bone formation or bone resorption indices were significantly and highly correlated with Z-score of BMD in the radius, but not at lumbar spine. Urinary Dpd was significantly correlated with BMD changes at both lumbar spine and radius and at all time points over the two years after PTX. These correlations were most potent among bone metabolic indices in this study. The measurement of urinary Dpd would be useful for predicting long-term changes in BMD at radial and lumbar spine after PTX than other bone metabolic indices.

Key words

Primary hyperparathyroidism - parathyroidectomy - bone metabolic indices - bone mineral density - osteoporosis

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Hiroshi Kaji, M. D.

Division of Endocrinology/Metabolism, Neurology and Hematology/Oncology, Department of Clinical Molecular Medicine

Kobe University Graduate School of Medicine · 7-5-1 Kusunoki-cho · Chuo-ku · Kobe 650-0017 · Japan

Phone: +81 (78) 382-5885

Fax: +81 (78) 382-5899 ·

Email: hiroshik@med.kobe-u.ac.jp