Skeletal phenotypes in postmenopausal women affected by primary hyperparathyroidism

Area of Science:

• Endocrinology
• Osteoporosis Research
• Geriatric Medicine

Background:

• Primary hyperparathyroidism (PHPT) is often considered a mild condition.
• Skeletal health and fracture prevalence in postmenopausal women with PHPT require further investigation.

Purpose of the Study:

• To explore skeletal phenotypes in postmenopausal women with PHPT.
• To determine the prevalence of fractures in this patient group.
• To identify factors associated with fracture risk in PHPT.

Main Methods:

• Retrospective evaluation of 503 postmenopausal women with PHPT across four Italian osteoporosis centers.
• Data collection from clinical records.
• Hierarchical clusterization analysis to identify distinct skeletal phenotypes.

Main Results:

• 90% of women had low bone mineral density (BMD); approximately 30% reported fractures.
• Four distinct skeletal phenotypes were identified using cluster analysis.
• Fracture prevalence varied significantly across phenotypes, with one cluster showing 100% fracture incidence, older age, and higher cardiovascular disease comorbidity.

Conclusions:

• Skeletal involvement in PHPT is heterogeneous, with varying fracture prevalence.
• Fracture risk is not solely related to PHPT severity.
• Age, BMI, and BMD at lumbar and femur sites are crucial factors in assessing bone health in postmenopausal women with PHPT.