Changes in Bone Mineral Density After Parathyroidectomy in Patients With Primary Hyperparathyroidism

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.