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Horm Metab Res 2012; 44(06): 476-481
DOI: 10.1055/s-0032-1308998
Humans, Clinical
© Georg Thieme Verlag KG Stuttgart · New York

Bone Metabolism in Patients with Primary Hyperparathyroidism Before and After Surgery

K. Kerschan-Schindl
1    Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
,
P. Riss
2    Section “Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
,
C. Krestan
3    Department of Radiology, Medical University of Vienna, Vienna, Austria
,
M. Rauner
4    Ludwig Bolzmann Institute of Ageing Research, Vienna, Austria
5    Division of Endocrinology, Diabetes, and Metabolic Bone Diseases, Department of Medicine III, Technical University, Dresden, Germany
,
C. Bieglmayer
6    Department of Biochemistry, Medical University of Vienna, Vienna, Austria
,
A. Gleiss
7    Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
,
V. Fialka-Moser
1    Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
,
B. Niederle
2    Section “Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
,
P. Pietschmann
8    Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
› Author Affiliations
Further Information

Publication History

received 29 November 2011

accepted 07 March 2012

Publication Date:
11 April 2012 (online)

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Abstract

Primary hyperparathyroidism (PHPT) is accompanied with a reduced bone mineral density (BMD) and an increased risk of fracture. Surgery is the only option for cure. It is hypothesized that in patients with PHPT bone metabolism normalizes after parathyroidectomy (PTX) and that BMD gradually increases. Fifty-two patients with PHPT who underwent surgery were prospectively followed for 1 year. Biochemical analyses were performed at baseline and 1, 4, 7 days; 6 weeks; and 3, 6, and 12 months, and BMD before and one year after surgery. Parathyroid hormone (PTH), calcium, and the bone resorption marker dropped immediately, but transiently after PTX, bone formation decreased more slowly. Osteoprotegerin (OPG) as well as cathepsin K did not show significant changes. BMD of the lumbar spine, but not of the femoral neck, increased significantly within one year after surgery. Moderate correlations existed between the changes of total calcium, ionized calcium, as well as bone-specific alkaline phosphatase and changes of the lumbar BMD. Patients who needed postoperative supplementation with calcium and vitamin D had significantly higher PTH levels. Some gender-specific differences in patients with PHPT were observed. In patients with PHPT, males appear to be more severely affected than females. Within the first year after PTX, bone metabolism normalized, and BMD of the lumbar spine increased. Patients who needed a supplementation with calcium and vitamin D after PTX preoperatively had higher serum levels of PTH.

Key words

primary hyperparathyroidism - surgery - bone metabolism - gender - OPG - cathepsin K
 

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