ECE2007 Poster Presentations (1) (659 abstracts)
Primary hyperparathyroidism is associated with an increased risk of vertebral fracture assessed by morphometric x-ray absorptiometry
Giuseppe Viccica 1 , Edda Vignali 1 , Daniele Diacinti 2 , Romano Del Fiacco 2 , Tamara Giacomelli 1 , Luisella Cianferotti 1 , Filomena Cetani 1 , Antonietta Picone 1 , Chiara Banti 1 , Aldo Pinchera 1 & Claudio Marcocci 1
1University of Pisa, Pisa, Italy; 2University La Sapienza, Roma, Italy.
Primary hyperparathyroidism (PHPT) is a frequent cause of secondary osteoporosis, but its role about the fracture is still controversial. We evaluated 157 consecutive postmenopausal patients with PHPT compared with two control subjects (C), each one matched for age and month-since-menopause (MSM). We measured ionized calcium (Ca2+), parathyroid hormone (PTH), 25-OH-vitamin D (25-OH vit D), osteocalcin (OC), bone alkaline phosphatase (B-ALP) and serum and urinary cross-laps (S-CTX and U-CTX, respectively). Bone mineral density (BMD) were measured at spine (anterior-posterior, L1-L4) (BMD-V), femur (neck and total) (BMD-N and BMD-T, respectively) and radius (1/3 distal) (BMD-R) by dual energy X-ray absorptiometry (DXA) technique using a QDR-4500 (Hologic, Inc., Bedford, MA, USA). We also acquired lateral scan of the spine from T4 to L4 using the DXA machine. Morphometric X-ray absorptiometry (MXA) was performed by a trained operator on the lateral DXA images, using the software supplied by the manufacturer. Reduction of anterior, middle or posterior vertebral height were classified as mild (20–25%), moderate (25–40%) or severe (>40%) vertebral fracture, according to visual semiquantitative Genant’s method. No difference was found between PHPT and C groups in age, weight, height, body mass index (BMI) and MSM. The prevalence of vertebral fracture was higher in PHPT (26.7%, n=42) than C (5.4%; n=17) (P<0.0001) [odds ratio (OD) between PHPT and C was 6.38 (CI=1.66–14.31)]. BMD-N and BMD-R of PHPT fractured patients were significantly lower than unfractured ones (P<0.002 and P<0.0005, respectively). In the PHPT group, no difference was found in Ca2+, PTH, 25-OH vit D, OC, B-ALP, S-CTX and U-CTX between fractued and unfractured patients. In conclusion, BMD reduction observed in PHPT patients might account for the increased prevalence of vertebral fracture, but other factors may be involved in bone quality and fracture risk.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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