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Reviews in Endocrine and Metabolic Disorders

, Volume 20, Issue 3, pp 295–302 | Cite as

Risk of vertebral fractures in hypoparathyroidism

  • Anna Maria Formenti
  • Francesco Tecilazich
  • Raffaele Giubbini
  • Andrea GiustinaEmail author
Article
  • 199 Downloads

Abstract

Parathyroid hormone (PTH) exerts both anabolic and catabolic actions on bone,depending on the duration and periodicity of exposure. Hypoparathyroidism is defined by inadequate production of PTH in the presence oflow serum calcium. In hypoparathyroidism it has been reported an increase in corticaland trabecular bone mass, but it is still unknown if these quantitative variations maybe accompanied by qualitative ones and increased bone strength. Despite the extensive data available on the effects of hypoparathyroidism on bone, itseffect on the hard end point in this area which is the risk of fractures still remainsunresolved and highly debated. As a matter of fact no previous review has focused onthis relevant clinical topic. This review will deal with the various aspects of bone metabolism (turn-over,density, quality) in hypoparathyroidism, focusing on the few data available on therisk of fracture and in particular of morphometric vertebral fractures, the emerging way to assess actual skeletal fragility particularly in secondary forms of osteoporosis.

Keywords

Hypoparathyroidism Vertebral fractures Morphometry Parathyroid hormone Bone metabolism Bone mineral density Bone quality 

Abbreviations

PTH

Parathyroid hormone

CaSR

Calcium sensing receptor

TGFα

Transforming growth factor alpha

FGF23

Fibroblast growth factor 23

RANKL

Receptor activator of nuclear factor-kappaB ligand

IGF-1

Insulin-like growth factor 1

TNF

Tumor necrosis factor

BMD

Bone mineral density

vBMD

Volumetric bone mineral density

pQCT

Peripheral quantitative computed tomography

VF

Vertebral fractures

DEXA

Dual-energy X-ray absorptiometery

Ha

Anterior vertebral height

Hm

Middle vertebral height

Hp

Posterior vertebral height

GHD

Growth hormone deficiency

Notes

Compliance with ethical standards

Conflict of interest

Author AG has received research grants from Ipsen and Novartis. Author AG is consultant for Ipsen, Pfizer, Astellas, Abiogen and Shire. Author AMF is consultant for Shire and Abiogen. Author FT declares that he has no conflict of interest. Author RG declares that he has no conflict of interest.

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Copyright information

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

Authors and Affiliations

  • Anna Maria Formenti
    • 1
  • Francesco Tecilazich
    • 1
  • Raffaele Giubbini
    • 2
  • Andrea Giustina
    • 1
    Email author
  1. 1.San Raffaele Vita-Salute University Via OlgettinaMilanoItaly
  2. 2.University of BresciaBresciaItaly

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