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Does homocysteine contribute to bone disease in hyperparathyroidism?
Robin A Alley1, Emery L Chen, Todd D Beyer
1Department of General Surgery, Rush University Medical Center, 1653 W. Congress Pkwy., Chicago, IL 60612, USA.
American Journal of Surgery
|January 29, 2008
Summary
Hyperhomocysteinemia (HHCy) is uncommon in hyperparathyroidism (HPT) patients with normal kidney function but prevalent in those with renal insufficiency. HHCy correlates with bone metabolism markers in HPT.
Area of Science:
- Endocrinology
- Nephrology
- Bone Metabolism
Background:
- Osteoporosis is a known complication of hyperparathyroidism (HPT).
- Hyperhomocysteinemia (HHCy), an independent risk factor for osteoporotic fractures, is hypothesized to correlate with bone disease in HPT.
Purpose of the Study:
- To investigate the correlation between HHCy and bone disease in patients with HPT.
- To assess the prevalence of HHCy across different stages of renal function in HPT patients.
Main Methods:
- A database of 250 HPT patients was reviewed, categorized by renal function (normal, mild insufficiency, end-stage renal disease on dialysis).
- Serum homocysteine levels, bone metabolism markers, and bone density were analyzed.
Main Results:
- HHCy prevalence was 5% in normal renal function, 82% in mild insufficiency, and 78% in end-stage renal disease.
- Mean homocysteine levels were significantly higher in patients with impaired renal function.
- Elevated bone metabolism markers increased with declining renal function.
Conclusions:
- HHCy is infrequent in HPT patients with normal renal function but significantly more common in those with renal insufficiency.
- HHCy correlates with other serum markers of bone metabolism in HPT.
- HHCy may serve as a useful indicator for monitoring bone disease progression or treatment response in HPT.
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