Chronic hypoparathyroidism is associated with increased cortical bone density evaluated using high-resolution peripheral quantitative computed tomography

Purpose This cross-sectional study aimed to assess bone mineral density (BMD), bone microarchitecture and fracture prevalence in women with chronic postsurgical hypoparathyroidism (hypoPT). Methods Twenty-seven women with postsurgical hypoPT and 44 age-matched healthy women were included. Dual-energ...

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Bibliographic Details
Published in:	Endocrine Vol. 82; no. 3; pp. 673 - 680
Main Authors:	Santa Rosa, Renata Gervais, Polonine, Simone, Pichone, Alinie, Gomes, Carlos Perez, Lima, Luís Felipe Cardoso, de Paula Paranhos Neto, Francisco, de Mendonça, Laura Maria Carvalho, Farias, Maria Lucia Fleiuss, Madeira, Miguel
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-12-2023 Springer Nature B.V
Subjects:	Bone density Bone mineral density Bone turnover Cancellous bone Collagen (type I) Computed tomography Cortical bone Cross-linking Diabetes Dual energy X-ray absorptiometry Endocrinology Fibroblast growth factor 23 Fractures Hip Humanities and Social Sciences Hypoparathyroidism Internal Medicine Medicine Medicine & Public Health multidisciplinary Original Article Procollagen Radius Risk assessment Science Spine (lumbar) Tibia Tomography Vertebrae Bone mineral density High-resolution peripheral quantitative computed tomography Fracture risk Hypoparathyroidism Bone microarchitecture
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Summary:	Purpose This cross-sectional study aimed to assess bone mineral density (BMD), bone microarchitecture and fracture prevalence in women with chronic postsurgical hypoparathyroidism (hypoPT). Methods Twenty-seven women with postsurgical hypoPT and 44 age-matched healthy women were included. Dual-energy X-ray absorptiometry was used to evaluate areal BMD and vertebral fracture assessment. High-resolution peripheral quantitative computed tomography assessed microarchitecture and volumetric BMD at the distal radius and tibia. Biochemical parameters, including fibroblast growth factor 23, C-terminal cross-linking telopeptide of type I collagen (ICTP), and procollagen type I N-terminal propeptide (P1NP), were also measured. Previous low-impact fractures were assessed and the 10-year fracture risk was estimated using the FRAX tool for the Brazilian population. Results No participant had prevalent clinical fractures, and both groups showed low risk for major and hip based on FRAX tool, but two hypoPT patients had moderate to severe morphometric vertebral fractures. Women with hypoPT had increased aBMD in the lumbar spine, femoral neck and total hip ( p < 0.05) and higher cortical vBMD in the radius ( p = 0.020) and tibia ( p < 0.001). Trabecular bone was not affected. Both P1NP and ICTP suggested low bone turnover rates, but no significant correlation was observed between bone density or microstructure and any of the biochemical parameters. Conclusions The prevalence of fragility fractures was low in HypoPT women and compatible with low fracture risk estimated by the FRAX tool. Patients had a higher aBMD and cortical vBMD than those of healthy control women, but the association with decreased bone turnover remains unclear.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1559-0100 1355-008X 1559-0100
DOI:	10.1007/s12020-023-03495-4