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Primary hyperparathyroidism and osteoporosis

G F Mazzuoli1, E D'Erasmo, D Pisani

  • 1II Clinica Medica, Policlinico Umberto I, La Sapienza University, Roma, Italy.

Aging (Milan, Italy)
|November 5, 1998
PubMed
Summary
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Primary hyperparathyroidism (PHPT) causes bone loss, increasing osteoporosis and fracture risk in younger individuals. However, parathyroid hormone (PTH) may protect older women

Area of Science:

  • Endocrinology
  • Bone Biology
  • Metabolic Bone Disease

Background:

  • Primary hyperparathyroidism (PHPT) is linked to bone resorption via parathyroid hormone (PTH).
  • Emerging evidence suggests PTH may also possess anabolic effects on bone.
  • Understanding these dual actions is crucial for managing PHPT-related skeletal complications.

Purpose of the Study:

  • To review the paradoxical effects of PTH in PHPT.
  • To analyze bone densitometric and histomorphometric data in PHPT patients.
  • To clarify the impact of PHPT on bone health across different age groups.

Main Methods:

  • Literature review of in vitro and in vivo studies.
  • Analysis of bone densitometry (BMD) measurements.
  • Evaluation of histomorphometric data from PHPT patients.

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Main Results:

  • Skeletal damage in PHPT primarily affects cortical bone; trabecular bone mineral content is preserved or increased.
  • Osteoporosis prevalence is higher in early postmenopausal women with PHPT.
  • Fracture incidence is elevated in younger PHPT patients but normalizes with age.

Conclusions:

  • PTH hypersecretion is a risk factor for osteoporosis and fractures in the young and early postmenopausal women.
  • PTH may offer a protective effect on trabecular bone in elderly postmenopausal women.
  • PHPT's skeletal effects are age- and site-dependent, highlighting complex PTH actions.