Endocrine Abstracts

Aim: Clinical presentation of primary hyperparathyroidism (PHPT) differs between populations. In this study, we aimed to examine bone mineral density (BMD) and bone metabolism parameters in newly diagnosed and untreated PHPT patients in a single endocrine center in İstanbul, Turkey.

Methods: Consecutive 256 PHPT patients (50.7±14 years, F/M:205/51) and 89 healthy controls (38.8±10 years, F/M:67/22) were included in the study. Serum calcium, phosphorus, parathyroid hormone (PTH), 25(OH) vitamin D, creatinine, 24-h urinary calcium were measured. DEXA method was used for bone mineral density (BMD) measurement.

Results: Twenty percent of PHPT patients were symptomatic and nephrolithiasis was shown in 20.3% of the patients. Serum calcium levels were 11.2±1.3 mg/dl and 9.6±0.3 mg/dl (P< 0.0001), serum PTH levels were 273.4±374 pg/ml and 61.3±28 pg/ml (P<0.001) and serum 25OH D levels were 21.9±20.1 ng/ml and 10.4±7.1 ng/ml (P<0.0001) for PHPT and control groups respectively. 24-h urinary calcium levels were 294.4±213.9 mg/day in PHPT group and 137±69.2 mg/day in healthy control group (P<0,0001). Femur neck BMD were 0.82±0.15 g/cm² and 0.98±0.14 g/cm² (P<0.0001) for PHPT and control groups respectively. Femur neck and lumber BMDs, T and Z scores were observed significantly lower in PHPT group compared to healthy controls group (P<0.0001). Femur neck and lumber BMD levels showed negative correlation with PTH in PHPT patients (r=−0.37, P<0.0001). There were osteoporosis in 13.4 percent (n:34) and osteopenıa in 9.9 percent (n:25) of PHPT patients.

Conclusion: In our group of patients osteoporosis was diagnosed lower than expected but BMD measurements were lower in PHPT group. The results of this study show that bone turnover is increased and bone mineral density is decreased in PHPT patients, as stated in previous studies.