Characteristics of hyperparathyroid states in the Canadian multicentre osteoporosis study (CaMos) and relationship to skeletal markers. (1st September 2014)

• Record Type: Journal Article
• Authors: Berger, C.; Almohareb, O.; Langsetmo, L.; Hanley, D.A.; Kovacs, C.S.; Josse, R.G.; Adachi, J.D.; Prior, J.C.; Towheed, T.; Davison, K.S.; Kaiser, S.M.; Brown, J.P.; Goltzman, D.; the CaMos Research Group
• Is Part Of: Clinical endocrinology. Volume 82:Number 3(2015:Mar.)
• Page Start: 359
• Page End: 368
• Publication Date: 2014-09-01
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12569
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12569-abs-0001"> <title>Summary</title> <sec id="cen12569-sec-0001" sec-type="section"> <title>Context</title> <p>PTH is an essential regulator of mineral metabolism; PTH hypersecretion may result in hyperparathyroidism including normocalcaemic, primary and secondary hyperparathyroidism.</p> </sec> <sec id="cen12569-sec-0002" sec-type="section"> <title>Objective</title> <p>To examine the characteristics of participants with hyperparathyroid states and the relationship to bone mineral density (BMD).</p> </sec> <sec id="cen12569-sec-0003" sec-type="section"> <title>Design and participants</title> <p>A cross‐sectional study of 1872 community‐dwelling men and women aged 35+ years (mostly Caucasian) with available serum PTH from Year 10 Canadian Multicentre Osteoporosis Study follow‐up (2005–07). PTH was determined using a second‐generation chemiluminescence immunoassay.</p> </sec> <sec id="cen12569-sec-0004" sec-type="section"> <title>Outcome measures</title> <p>L1‐L4, femoral neck and total hip BMD.</p> </sec> <sec id="cen12569-sec-0005" sec-type="section"> <title>Results</title> <p>We established a PTH reference range (2·7–10·2 pmol/l) based on healthy participants (i.e. normal serum calcium, serum 25‐hydroxyvitamin D, kidney function and body mass index, who were nonusers of antiresorptives, glucocorticoids and diuretics and not diagnosed with diabetes or thyroid disease). Participants with PTH levels in the upper reference range (5·6–10·2 pmol/l), representing a prevalence of 10·7%, had lower femoral neck and total hip BMD, by 0·030 g/cm<sup>2</sup> [95% confidence interval: 0·009; 0·051] and 0·025 g/cm<sup>2</sup> (0·001; 0·049), respectively, than those with levels 2·7–5·6 pmol/l. Participants with normocalcaemic and secondary hyperparathyroidism also had lower total hip BMD than those with levels 2·7–5·6 pmol/l, and CaMos prevalences of normocalcaemic, primary and secondary hyperparathyroidism were 3·3%, 1·4% and 5·2%, respectively.</p> </sec> <sec id="cen12569-sec-0006" sec-type="section"> <title>Conclusion</title> <p>We found reduced BMD in participants with accepted hyperparathyroid states but also a notable proportion of other participants that might benefit from having lower PTH levels.</p> </sec> </abstract>