Background: The main consequence of bone hyperparathyroidism is the increase of bone remodelling. The X-Ray absorptiometry (DXA) has consistently found a decrease in bone density in cortical areas, particularly in the proximal third of the radius, to a lesser extent at the upper end of the femur. The lumbar spine is rarely achieved. The objective of our study is to determine the number of osteoporotic patients by DXA in primary hyperparathyroidism.
Methods: This is a single-centre study, analytical, conducted in Rheumatology, of 63 patients followed in consultation bone diseases for hyperparathyroidism. The inclusion criteria were the patients with primary hyperparathyroidism was confirmed. The exclusion criteria were patients with other risk factors of bone fragility (inflammatory arthritis, steroid medication, diabetes), apart from age and menopausal status. Bone mineral density was measured at three sites with the same device (Hologic), together with the phospho-calcic analysis before parathyroidectomy. Osteoporosis was defined as classified by the World Health Organization.
Results: Among 63 patients, 30 had primary hyperparathyroidism, and 17 answered to the strict inclusion criteria. There were 15 women and 2 men. The mean age was 72 years. 13 patients were postmenopausal. The mean body mass index was 22. 12 cases had densitometric osteoporosis proximal 1/3 of the distal radius, associated with osteoporosis at the lumbar spine in 7 cases and femur in 6 cases. Osteoporosis was at three sites in 5 cases. Patients were treated with conservative measures or surgical treatment as the concensus NIH, 2009.
Conclusion: Our results are consistent with literature. The majority of patients had osteoporosis at the cortical site. However, other sites including the lumbar spine and femur may also be affected. it was revealed a predominant under PHPT with spinal disease group that represents about 15 to 20% and 59% of asymptomatic patients have a higher bone loss 10% to at least one of these sites.
Disclosure: The authors declared no competing interests.