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This version published online on June 10, 2008
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-2480
A more recent version of this article appeared on August 1, 2008
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Submitted on November 7, 2007
Accepted on May 29, 2008

Improved Peripheral Cortical Bone Geometry after Surgical Treatment of Primary Hyperparathyroidism in Postmenopausal Women

HIROSHI KAJI*, MIKA YAMAUCHI, RIKAKO NOMURA, and TOSHITSUGU SUGIMOTO

Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; Internal Medicine 1, Shimane University Faculty of Medicine, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan

* To whom correspondence should be addressed. E-mail: hiroshik{at}med.kobe-u.ac.jp.

Context: Cortical bone geometry is one of the most important components of bone strength. Excess endogenous PTH or intermittent PTH administration affects cortical bone geometry; however, the changes in cortical bone geometry in patients with primary hyperparathyroidism (pHPT) after parathyroidectomy (PTX) remain unknown.

Objective: The present study was performed to examine the longitudinal effects of treating endogenous PTH excess on cortical bone geometry in postmenopausal patients with pHPT by employing peripheral quantitative computed tomography (pQCT).

Patients: Twenty postmenopausal pHPT patients and thirty postmenopausal control subjects matched for age participated in this study.

Main outcome measures: Volumetric BMD, cortical bone geometric parameters, SSIp (polar strength strain index) and polar cross-sectional moment of inertia (pCSMI) were measured using pQCT at the radius during the year after PTX.

Results: After 1 year, total and cortical BMD significantly increased after PTX in the pHPT group (2.9 and 1.6%, respectively), while they significantly decreased in the control group (-2.1 and -1.3%, respectively). Significant decreases in cortical thickness and area were observed in the control group (-3.0 and -2.5%, respectively). In contrast, the pHPT group showed increases in cortical thickness and area (8.5 and 7.6%, respectively) as well as SSIp 1 year after PTX.

Conclusion: The present longitudinal study showed significant beneficial changes in volumetric BMD, cortical bone geometry and bone strength index after PTX in postmenopausal women with pHPT.
Key words: Primary hyperparathyroidism • Bone geometry • Bone mineral density • Parathyroidectomy






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