Zhixing Song, Shivani Reddy, Christopher Wu, Andrea Gillis, Jessica Fazendin, Brenessa Lindeman, Herbert Chen
{"title":"Changes in Bone Mineral Density After Parathyroidectomy in Patients With Primary Hyperparathyroidism.","authors":"Zhixing Song, Shivani Reddy, Christopher Wu, Andrea Gillis, Jessica Fazendin, Brenessa Lindeman, Herbert Chen","doi":"10.1016/j.jss.2025.01.003","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Patients with primary hyperparathyroidism (PHPT) are prone to low bone mineral density (BMD). This study aimed to explore factors associated with improved bone health after parathyroidectomy (PTx).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent PTx for PHPT at our institution between 2016 and 2020. Patients who had a dual-energy X-ray absorptiometry (DEXA) scan before and after surgery were included. T score in the lumbar spine, femoral neck, hip, and radius were examined longitudinally.</p><p><strong>Results: </strong>The cohort included 36 patients, predominantly White (80.6%) and female (97.2%), with an average age of 67 ± 8 ys. Before surgery, 25% were diagnosed with osteoporosis, 50% with osteopenia, and 25% had normal BMD. The mean preoperative calcium was 10.5 ± 0.7 mg/dL, and the median parathyroid hormone was 105 (75, 131) pg/mL. The median interval between the preoperative DEXA scan and surgery was 357 (134, 920) days. There was a significant improvement in the femoral neck T-score after surgery (-1.33 ± 1.05 presurgery versus -1.16 ± 1.19 postsurgery, P = 0.016), but not in other regions. A longer time between the preoperative DEXA scan and surgery was associated with a lower likelihood of T-score improvement after surgery (odds ratio = 0.92, 95% confidence interval 0.85 - 0.99).</p><p><strong>Conclusions: </strong>PTx improves BMD in the femoral neck of patient with PHPT. Early surgical intervention may be associated with better skeletal outcomes in PHPT.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"431-436"},"PeriodicalIF":1.8000,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jss.2025.01.003","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Patients with primary hyperparathyroidism (PHPT) are prone to low bone mineral density (BMD). This study aimed to explore factors associated with improved bone health after parathyroidectomy (PTx).
Methods: We conducted a retrospective analysis of patients who underwent PTx for PHPT at our institution between 2016 and 2020. Patients who had a dual-energy X-ray absorptiometry (DEXA) scan before and after surgery were included. T score in the lumbar spine, femoral neck, hip, and radius were examined longitudinally.
Results: The cohort included 36 patients, predominantly White (80.6%) and female (97.2%), with an average age of 67 ± 8 ys. Before surgery, 25% were diagnosed with osteoporosis, 50% with osteopenia, and 25% had normal BMD. The mean preoperative calcium was 10.5 ± 0.7 mg/dL, and the median parathyroid hormone was 105 (75, 131) pg/mL. The median interval between the preoperative DEXA scan and surgery was 357 (134, 920) days. There was a significant improvement in the femoral neck T-score after surgery (-1.33 ± 1.05 presurgery versus -1.16 ± 1.19 postsurgery, P = 0.016), but not in other regions. A longer time between the preoperative DEXA scan and surgery was associated with a lower likelihood of T-score improvement after surgery (odds ratio = 0.92, 95% confidence interval 0.85 - 0.99).
Conclusions: PTx improves BMD in the femoral neck of patient with PHPT. Early surgical intervention may be associated with better skeletal outcomes in PHPT.
期刊介绍:
The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories.
The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.