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Peripheral bone mineral density in correlation to disease-related predisposing conditions in patients with multiple endocrine neoplasia type 1

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Abstract

Background and aim: Patients with multiple endocrine neoplasia type 1 (MEN1) often have low bone mineral density (BMD) attributed to primary hyperparathyroidism (pHPT). However, in MEN1 patients, other endocrine dysfunctions and conditions such as hypercortisolism, hypogonadism, and GH deficiency due to pituitary manifestation, and surgery on the upper gastrointestinal tract may affect BMD. Subjects and methods: In 23 patients with MEN1 (10 females, 13 males; 46±12 yr), BMD was determined by quantitative computed tomography at the forearm (pqCT), compared to a reference population and related to different conditions suspected to affect bone metabolism in MEN1. Results: In this cohort, Z-score for trabecular BMD was −0.85±1.18 and for total BMD −1.16±1.04. There was a similar trend towards lower BMD in uncontrolled hyperparathyroidism, hypercortisolism, hypogonadism/GH deficiency and the state after surgery at the upper gastrointestinal tract. Conclusions: These data while confirming previous observations on reduced BMD in patients with MEN1, however, challenge its only or even predominant association with pHPT. Other conditions such as hypercortisolism, somatotrophic/gonadotrophic pituitary insufficiency, and previous upper gastrointestinal surgery seem to be factors contributing to the risk of developing osteoporosis.

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Authors and Affiliations

  1. Division of Endocrinology and Diabetology, Endocrine Laboratory, Faculty of Medicine, Philipp’s University Marburg, University Hospital Giessen and Marburg, Baldinger Strasse, D - 35033, Marburg, Germany

    P. H. Kann MD, PhD, MA (Professor of Medicine, Head) & J. Klüsener

  2. Department of Surgery, Faculty of Medicine and University Hospital, Philipp’s University, Marburg, Germany

    D. Bartsch, P. Langer & J. Waldmann

  3. Division of Gynecological Endocrinology, Faculty of Medicine and University Hospital, Philipp’s University, Marburg, Germany

    P. Hadji

  4. Institute for Clinical Research and Development, Mainz, Germany

    A. Pfützner

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  1. P. H. Kann MD, PhD, MA
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Kann, P.H., Bartsch, D., Langer, P. et al. Peripheral bone mineral density in correlation to disease-related predisposing conditions in patients with multiple endocrine neoplasia type 1. J Endocrinol Invest 35, 573–579 (2012). https://doi.org/10.3275/7880

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