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

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Abstract

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.

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Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by R.G.S.R., S.P., A.P., C.P.G., L.F.C.L., F.d.P.P.N., L.M.C.d.M., M.L.F.F. and M.M. The first draft of the manuscript was written by R.G.S.R., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Funding

This work was supported by FINEP (grant numbers 01.16.0079.00); a brazilian public company for the promotion of science, technology and research. FINEP had no involvement in study design, data collection, analysis and interpretation, as well as conclusion and article submission.

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Authors and Affiliations

  1. Endocrinology Division, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Renata Gervais Santa Rosa, Simone Polonine, Francisco de Paula Paranhos Neto, Maria Lucia Fleiuss Farias & Miguel Madeira

  2. Nephrology Division, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Renata Gervais Santa Rosa, Alinie Pichone & Carlos Perez Gomes

  3. Nuclear Engineering Program, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Luís Felipe Cardoso Lima

  4. Rheumatology Division, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Laura Maria Carvalho de Mendonça

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  1. Renata Gervais Santa Rosa
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  2. Simone Polonine
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Correspondence to Renata Gervais Santa Rosa.

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This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the Research Ethics Committee and registered at Plataforma Brazil (CAAE 93448618.4.0000.5257).

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Informed consent was obtained from all the individual participants included in the study.

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Santa Rosa, R.G., Polonine, S., Pichone, A. et al. Chronic hypoparathyroidism is associated with increased cortical bone density evaluated using high-resolution peripheral quantitative computed tomography. Endocrine 82, 673–680 (2023). https://doi.org/10.1007/s12020-023-03495-4

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