Calcified Tissue International

, Volume 104, Issue 4, pp 382–389 | Cite as

Effect of Endogenous Parathyroid Hormone on Bone Geometry and Skeletal Microarchitecture

  • A Ram Hong
  • Ji Hyun Lee
  • Jung Hee Kim
  • Sang Wan KimEmail author
  • Chan Soo Shin
Original Research


Parathyroid hormone (PTH) has anabolic or catabolic effects on bones; however, the skeletal effect of endogenous PTH on cortical and trabecular bones is not yet clear. Therefore, we aimed to examine the effects of an excess and a deficiency of endogenous PTH on the lumbar spine trabecular bone score (TBS) and bone geometry using dual-energy X-ray absorptiometry. We retrospectively included 70 patients with primary hyperparathyroidism (PHPT), 26 patients with idiopathic or postoperative hypoparathyroidism (HypoPT), and 96 normal controls matched by age, sex, and body mass index. The bone mineral density (BMD) at the lumbar spine, femur neck, and total hip was higher in the HypoPT, followed by the controls and PHPT group (all P < 0.001). The TBS was significantly decreased in the PHPT group compared to the controls (P = 0.021); however, statistical significance disappeared after adjusting for the lumbar BMD (P = 0.653). There were no significant differences in the TBS between the HypoPT group and controls as well as the PHPT and HypoPT group. As for bone geometry parameters, the cross-sectional area, cross-sectional moment of inertia, and section modulus were higher in the HypoPT, followed by the controls and PHPT group (all P < 0.001); statistical significance remained after adjusting for the total hip BMD. We also observed a significantly increased cortical neck width in the HypoPT group compared to the PHPT group (P = 0.009). The buckling ratio was higher in the PHPT than the HypoPT group and controls (P = 0.018 and P = 0.013, respectively). The present study demonstrated that an excess of endogenous PTH had catabolic effects on both cortical and trabecular bones. Under conditions of endogenous PTH deficiency, the effect on cortical bone was pronounced, but that on trabecular bone was modest.


Parathyroid hormone Bone mineral density Trabecular bone score Bone geometry 



This work was supported by Grant 042017-0280 from Seoul National University Hospital, and Seoul National University Hospital Research Fund (Grant No. 25-2014-0120).

Compliance with Ethical Standards

Conflict of interest

A Ram Hong, Ji Hyun Lee, Jung Hee Kim, Sang Wan Kim, and Chan Soo Shin declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

All procedures performed in this study involving human participants were in accordance with the Ethical Standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments. This study was approved by the institutional review board of Seoul National University Hospital. No investigations in animals were carried out in this study. The need for informed consent was waived due to the retrospective nature of the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal MedicineChonnam National University Medical SchoolGwangjuSouth Korea
  2. 2.Department of Internal MedicineSeoul National University College of MedicineSeoulSouth Korea
  3. 3.Department of Internal MedicineSeoul Metropolitan Government Boramae Medical CenterSeoulSouth Korea

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