Primary hyperparathyroidism: Short-term changes in bone remodeling and bone mineral density following parathyroidectomy

被引:67
作者
Christiansen, P
Steiniche, T
Brixen, K
Hessov, I
Melsen, F
Heickendorff, L
Mosekilde, L
机构
[1] Univ Aarhus, Aarhus Kommune Hosp, Dept Surg, DK-8000 Aarhus, Denmark
[2] Univ Aarhus, Aarhus Kommune Hosp, Inst Pathol, DK-8000 Aarhus, Denmark
[3] Univ Aarhus, Aarhus Kommune Hosp, Dept Endocrinol & Metab, DK-8000 Aarhus, Denmark
[4] Univ Aarhus, Aarhus Kommune Hosp, Dept Clin Biochem, DK-8000 Aarhus, Denmark
关键词
hyperparathyroidism; bone density; bone mineral density; bone remodeling; bone histomorphometry; follow-up study;
D O I
10.1016/S8756-3282(99)00150-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Changes in bone remodeling and bone mineral density were observed during a period of 6 months after surgery in 24 patients with primary hyperparathyroidism (20 women and 4 men; age 54 +/- 12 years, range 26-69 years). All bone markers declined significantly within the 6 month follow-up period, but the time course for changes in renal N-terminal telopeptide of type 1 collagen (NTx) excretion differed from those of the other markers by a steep and significant reduction (p < 0.05) after less than 1 month. During the 6 month period, bone mineral density (BMD) increased significantly at all sites measured (p < 0.05) apart from the femoral neck and the proximal and midforearm, The greatest increase of 4.2% was observed in the trochanteric region (p < 0.001), The increase in BMD in spine, trochanteric, and intertrochanteric regions of the hip correlated inversely with baseline forearm BMD values (p < 0.05). Baseline bone markers (serum alkaline phosphatase [AP], serum bone AP, serum pyridinoline crosslinked telopeptide of type 1 collagen, urinary hydroxyproline, urinary osteocalcin), as well as baseline histomorphometric indices of bone turnover (eroded and labeled surface, bone formation rate, activation frequency, and cortical porosity) were positively correlated with changes in spinal BMD over 6 months (p < 0.05). It was concluded that, within 6 months after parathyroidectomy, patients with primary hyperparathyroidism obtain normalization of bone remodeling and a substantial increase in bone mineral density in regions rich in cancellous bone but no significant changes in regions with predominantly cortical bone. (C) 1999 by Elsevier Science Inc. All rights reserved.
引用
收藏
页码:237 / 244
页数:8
相关论文
共 39 条
[1]  
ABUGASSA S, 1990, SURGERY, V107, P128
[2]  
ALHAVA EM, 1988, ACTA CHIR SCAND, V154, P345
[3]  
[Anonymous], 1974, Scand J Clin Lab Invest, V33, P291, DOI 10.3109/00365517409082499
[4]  
BILEZIKIAN J P, 1991, Journal of Bone and Mineral Research, V6, pS85
[5]   EFFICACY OF WHEAT-GERM LECTIN-PRECIPITATED ALKALINE-PHOSPHATASE IN SERUM AS AN ESTIMATOR OF BONE MINERALIZATION RATE - COMPARISON TO SERUM TOTAL ALKALINE-PHOSPHATASE AND SERUM BONE GLA-PROTEIN [J].
BRIXEN, K ;
NIELSEN, HK ;
ERIKSEN, EF ;
CHARLES, P ;
MOSEKILDE, L .
CALCIFIED TISSUE INTERNATIONAL, 1989, 44 (02) :93-98
[6]  
BROCKSTEDT H, 1995, BONE, V16, P109, DOI 10.1016/8756-3282(95)80020-Q
[7]   PRIMARY HYPERPARATHYROIDISM - ILIAC CREST TRABECULAR BONE VOLUME, STRUCTURE, REMODELING, AND BALANCE EVALUATED BY HISTOMORPHOMETRIC METHODS [J].
CHRISTIANSEN, P ;
STEINICHE, T ;
VESTERBY, A ;
MOSEKILDE, L ;
HESSOV, I ;
MELSEN, F .
BONE, 1992, 13 (01) :41-49
[8]   Primary hyperparathyroidism: Biochemical markers and bone mineral density at multiple skeletal sites in Danish patients [J].
Christiansen, P ;
Steiniche, T ;
Brixen, K ;
Hessov, I ;
Melsen, F ;
Charles, P ;
Mosekilde, L .
BONE, 1997, 21 (01) :93-99
[9]   PRIMARY HYPERPARATHYROIDISM - CHANGES IN TRABECULAR BONE REMODELING FOLLOWING SURGICAL-TREATMENT - EVALUATED BY HISTOMORPHOMETRIC METHODS [J].
CHRISTIANSEN, P ;
STEINICHE, T ;
MOSEKILDE, L ;
HESSOV, I ;
MELSEN, F .
BONE, 1990, 11 (02) :75-79
[10]   PRIMARY HYPERPARATHYROIDISM - ILIAC CREST CORTICAL THICKNESS, STRUCTURE, AND REMODELING EVALUATED BY HISTOMORPHOMETRIC METHODS [J].
CHRISTIANSEN, P ;
STEINICHE, T ;
BROCKSTEDT, H ;
MOSEKILDE, L ;
HESSOV, I ;
MELSEN, F .
BONE, 1993, 14 (05) :755-762