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Site specific differences in vBMD and geometry in postmenopausal women with primary hyperparathyroidism

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Abstract

Purpose

Primary Hyperparathyroidism (PHPT) is associated with catabolic effects at both trabecular and cortical bone. Mechanical loading is one of the most important natural anabolic stimuli for bone at all ages. The present study was designed to assess the impact of PHPT on vBMD and bone geometry using peripheral quantitative computed tomography (pQCT) at the radius and tibia, sites with similar structural characteristics, but subject to different loading conditions.

Methods

We evaluated the impact of PHPT on bone, by comparing the z-scores of volumetric Bone Mineral Density (vBMD) and indices of bone geometry simultaneously at the tibia and the radius by pQCT, skeletal sites with similar structure, but subject to different loading conditions. Forty-one postmenopausal women with PHPT and 79 controls, comprised the study group.

Results

At both trabecular and cortical sites, vBMD and bone geometry indices were significantly lower in patients compared with controls. In patients with PHPT, apart from a lower z-score for total vBMD (p = 0.01) at the radius, there was no other difference between the radius and the tibia at the trabecular sites. On the contrary, at cortical sites, the z-scores of cortical bone mineral content (p = 0.02), cortical vBMD (p = 0.01) and cortical cross-sectional area (p = 0.05) were significantly lower at the radius compared with the tibia, indicating that cortical bone at the weight bearing tibia might be less affected by the catabolic actions of continuous parathyroid hormone (PTH) exposure. PTH levels were positively associated with the difference in z-scores of cort BMD (r = 0.439, p < 0.01) indicating that in more severe cases, as expressed by higher PTH levels, the deleterious effects at the non-weight bearing radius might be accentuated.

Conclusion

We found that in postmenopausal women with PHPT, both trabecular and cortical bone are adversely affected. However, at the weight bearing tibia as compared with the radius, the deleterious effects, especially on cortical bone, seem to be attenuated.

Trial registration number

NCT05426512, 21/06/2022, “retrospectively registered”.

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Author notes

  1. These authors contributed equally: E. Chronopoulos, S. Tournis

Authors and Affiliations

  1. Laboratory for Research of the Musculoskeletal System “Th. Garofalidis”, Medical School, National and Kapodistrian University of Athens, KAT General Hospital, Kifissia, Athens, Greece

    E. Karlafti, I. Dontas, K. Lampropoulou-Adamidou, A. Galanos, G. Trovas, E. Chronopoulos & S. Tournis

  2. Menopause Unit, Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    I. Lambrinoudaki

  3. 3rd Department of Orthopaedics, Medical School, National and Kapodistrian University of Athens, KAT General Hospital, Kifissia, Athens, Greece

    I. Vlamis

  4. Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, Greece

    K. Makris & I. Trifonidi

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  1. E. Karlafti
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Contributions

All listed authors contributed to the conception, design, acquisition, analysis and interpretation of the data and/or writing of the manuscript and that they all approved the version of the manuscript submitted to “Endocrine”.

Corresponding author

Correspondence to S. Tournis.

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The authors declare no competing interests.

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The protocol was approved by the ethics committee of KAT hospital and all procedures were conducted according to the recommendations of Good Clinical Practice and all other applicable local regulatory and ethical requirements and the Declaration of Helsinki (revised edition, Tokyo 2004).

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Written informed consent was obtained from all patients.

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Karlafti, E., Dontas, I., Lambrinoudaki, I. et al. Site specific differences in vBMD and geometry in postmenopausal women with primary hyperparathyroidism. Endocrine 83, 205–213 (2024). https://doi.org/10.1007/s12020-023-03491-8

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  • DOI: https://doi.org/10.1007/s12020-023-03491-8

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