专注于非骨质疏松症的绝经后妇女与无症状初级甲状腺功能障碍症:一个单心系列
Elena Castellano1, Roberto Attanasio2, Alberto Boriano3
1Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy.
概括
在没有骨质疏松症的绝经后妇女中,无症状的原发性副甲状腺症 (aPHPT) 是常见的. 许多人不需要手术,但他们的骨折风险与那些需要手术的人相似.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 老年医学 老年医学
背景情况:
- 原发性偏甲状腺症 (PHPT) 是一种常见的内分泌疾病,特别是在绝经后的妇女中.
- 骨质疏松症 (OP) 经常与PHPT共存.
- 没有OP的无症状PHPT (aPHPT) 患者的临床特征,特别是绝经后的女性,仍未得到充分研究.
研究的目的:
- 为了评估无症状PHPT (aPHPT) 并且没有骨质疏松症的绝经后妇女.
- 为了比较OP和没有OP的aPHPT患者之间的临床,生化和骨健康参数.
- 评估没有OP的aPHPT患者的手术候选和骨折风险.
主要方法:
- 追溯的横截面研究.
- 从500个PHPT病例的数据库中包括178名绝经后aPHPT患者.
- 亚组之间的临床,生化,骨密度计和FRAX分数的比较.
主要成果:
- 确定了85名没有OP的aPHPT患者;他们的数据与有OP的93名aPHPT患者相比,除了后者较高的骨性酸酶.
- 在没有OP的85名aPHPT患者中,有45人满足了手术标准,并且与不符合标准的40人相比,血清PTH和含量显著增加,酸盐和eGFR降低.
- 在 aPHPT 患者之间没有观察到骨密度计 (T-score) 或FRAX计算的10年骨折风险的显著差异,这些患者没有OP,符合手术标准和那些不符合手术标准.
结论:
- 经更年期后的妇女有PHPT和没有OP构成了PHPT患者的重要亚组.
- 这些没有OP的aPHPT患者中,大约有一半不符合标准的外科手术标准.
- 尽管存在生物化学差异,骨折风险评估 (T分数和FRAX) 在这个队列中没有区分外科和非外科候选人,这表明需要个性化管理决策.
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