Primary hyperparathyroidism is common in postmenopausal women with forearm fracture and low bone mineral density

The most common etiologies of osteoporosis in women are estrogen deficiency and, later on in life, the functional changes caused by aging. There are, however, numerous causes of secondary bone loss. Little is known about the prevalence of concomitant disease in women with distal forearm fracture, which is the most common of the classical osteoporotic fractures.

Postmenopausal healthy women between 45 and 65 years of age with a forearm fracture were invited to join a prospective randomized study evaluating the effect of physical training on bone mineral density. The main inclusion criteria were previous forearm fracture and BMD T-score in the interval -1 to -3.0. Of the 167 postmenopausal women with a forearm fracture, 23% had a normal BMD, 59% had osteopenia, and 18% had osteoporosis.

Of the 119 patients meeting the BMD criteria for inclusion, one patient was found to have sprue, two were diagnosed with thyreotoxicos, and eight had primary hyperparathyroidism. The prevalence of primary hyperparathyroidism in this population was 6.7%, and thus three times higher than that previously observed in healthy Swedish postmenopausal women.

The data suggest an increased prevalence of primary hyperparathyroidism in women with forearm fracture and low bone mass, and imply the importance of basic laboratory screening in this population.