Weight gain after curative parathyroidectomy predicts increase in bone mineral density in patients with symptomatic primary hyperparathyroidism. (8th May 2020)

• Record Type: Journal Article
• Authors: Pal, Rimesh; Arya, Ashutosh K.; Aggarwal, Anshita; Singh, Priyanka; Dahiya, Divya; Sood, Ashwani; Singh, Tulika; Ram, Sant; Bhansali, Anil; Bhadada, Sanjay K.
• Is Part Of: Clinical endocrinology. Volume 93:Number 1(2020)
• Page Start: 28
• Page End: 35
• Publication Date: 2020-05-08
• Subjects: bone mineral density -- DEXA -- primary hyperparathyroidism -- weight gain; Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.14195
• Languages: English
• ISSNs: 0300-0664

Abstract

Abstract: Background: Primary hyperparathyroidism (PHPT) results in reduction of bone mineral density (BMD) and an increased risk of pathological fractures. Curative surgery does improve BMD; however, the magnitude of rise and predictive factors are highly variable amongst the hitherto available studies. Objectives: To quantify the magnitude of improvement in BMD after curative surgery in patients with symptomatic PHPT and dissect out the possible clinical and biochemical parameters predicting the BMD rise. Methods: We conducted a retrospective study of symptomatic PHPT patients undergoing surgery between August 2016 and July 2018. Patients achieving biochemical cure with pre‐ and post‐operative (at least 1 year after surgery) dual‐energy X‐ray absorptiometry scans performed were included in the study. Results: After exclusion, 63 patients were included in the study (M:F = 2:5; mean age = 44.8 years). At a median interval of 15 months, the median per cent change in BMD (ΔBMD) at lumbar spine (LS), total hip (TH), femoral neck (FN) and one‐third distal radius (forearm) was 6.5%, 7.0%, 8.1% and 6.9%, respectively. Following multiple linear regression analysis, baseline BMD was found to inversely predict ΔBMD at LS, TH and forearm. Pre‐operative iPTH positively predicted ΔBMD at LS and FN. Interestingly, 82.5% of the patients had a gain in body weight following curative surgery and change in body weight emerged as a significant positive predictor of ΔBMD at all sites. Conclusions: Curative surgery improves BMD at all sites in patients with symptomatic PHPT. Weight gain following surgery can be used as a positive clinical predictor of BMD rise.