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Bone Mineral Density Evolution and Incidence of Fractures in a Cohort of Patients With Primary Hyperparathyroidism Treated With Parathyroid Surgery vs Active Surveillance During 6 Years of Follow-Up

Abstract: Introduction: The need for parathyroidectomy to treat asymptomatic patients with primary hyperparathyroidism is controversial. The aim of this study was to assess the impact of parathyroidectomy vs. surveillance on skeletal outcomes such as bone mineral density (BMD) and incident fractures. Methods: This was a retrospective cohort study including 170 patients (112 treated with surgery and 58 subject to active surveillance) between 1991 and 2014. Changes in BMD in lumbar spine, femoral neck, total hip, and radius, and incidence of fractures, were monitored for 2-6 years. Results: Patients treated with surgery had BMD gains at 2years of 4.37%, as compared to 1.59% in non-operated patients (p<0.05) in the lumbar spine, 3.90% vs. 0.19% (p<0.05) in the femoral neck, and 2.70% vs. 0.14% (p<0.05) in total hip. Gain in BMD in the lumbar spine and femoral neck remained significant in operated patients at 4 and 6 years. No improvement was seen in the radius in operated patients. No significant difference was seen in fracture occurrence between operated and non-operated patients. Conclusion: Patients with primary hyperparathyroidism treated with surgery experience greater BMD gains than non-operated patients, especially in the lumbar spine and femoral neck. The risk of fracture does not decrease in the group of operated patients.

 Fuente: Endocrinol Diabetes Nutr . 2019 Jan;66(1):41-48

 Editorial: Elsevier España

 Año de publicación: 2019

 Nº de páginas: 8

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.endinu.2018.05.010

 ISSN: 2530-0164,2530-0172

 Url de la publicación: https://doi.org/10.1016/j.endinu.2018.05.010

Autoría

RAMOS, LAURA

MARIA PIEDRA LEON

MARIA TERESA GARCIA UNZUETA

MARIA DEL CORAL MONTALBAN CARRASCO

JOSE ANTONIO AMADO SEÑARIS