Impaired geometry, volumetric density, and microstructure of cortical and trabecular bone assessed by HR-pQCT in both sporadic and MEN1-related primary hyperparathyroidism
- 44 Downloads
This study evaluated bone features of PHPT using HR-pQCT. The results showed both cortical and trabecular bones were significantly impaired in PHPT patients. Male and female PHPT patients suffered similar damages in bone. HR-pQCT indices were not observed to differ in MEN1 and sporadic PHPT patients.
High-resolution peripheral quantitative CT is a novel imaging technique used to separately assess trabecular and cortical bone status of the radius and tibia in vivo. Using HR-pQCT, we aimed to evaluate bone features of primary hyperparathyroidism patients in a Chinese population and reveal similarities and differences in bone features in multiple endocrine neoplasia type 1–related PHPT and sporadic PHPT patients in the Chinese population.
A case-control study was designed. In 58 PHPT patients and 58 sex- and age-matched healthy controls, the distal radius and tibia were scanned using HR-pQCT. Areal bone mineral density (aBMD) was also determined in PHPT patients using dual-energy X-ray absorptiometry (DXA).
In comparison with controls, PHPT patients were observed to exhibit reduced volumetric BMD at the cortical and trabecular compartments, thinner cortices, and more widely spaced trabeculae. Significant differences were still observed when comparing data of female and male patients with age-matched controls separately. MHPT patients (n = 11) were found to have lower aBMD Z-scores in the lumbar spine, trochanteric region, and total hip compared with sporadic PHPT patients (n = 47), while no differences were observed in HR-pQCT indices between the two groups. In multiple linear regression models, no significant correlations were identified between PTH and HR-pQCT indices. However, height was found to positively correlate with HR-pQCT-derived trabecular indices at both the radius and tibia.
PHPT affects geometry, volumetric density, and microstructure in both the cortical and trabecular bones in both male and female Chinese patients. MHPT patients were observed to have reduced aBMD as determined by DXA in the lumbar spine and hip in comparison with sporadic PHPT patients. However, HR-pQCT indices were not observed to differ.
KeywordsBone microstructure Bone volumetric density High-resolution peripheral quantitative CT Multiple endocrine neoplasia type 1 Primary hyperparathyroidism
The authors thank the patients for their participation in the study.
This work was financially supported by the Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine (CAMS-I2M) and the National Natural Science Foundation of China (No. 81100559).
Compliance with ethical standards
The present study was approved by the Ethics Committee of Peking Union Medical College Hospital. Written informed content was obtained from all subjects, and this study was carried out according to the principles defined in the Declaration of Helsinki.
Conflicts of interest
- 1.Chen Q, Kaji H, Iu MF et al (2003) Effects of an excess and a deficiency of endogenous parathyroid hormone on volumetric bone mineral density and bone geometry determined by peripheral quantitative computed tomography in female subjects. J Clin Endocrinol Metab 88(10):4655–4658CrossRefGoogle Scholar
- 2.Silva BC, Costa AG, Cusano NE, Kousteni S, Bilezikian JP (2011) Catabolic and anabolic actions of parathyroid hormone on the skeleton. J Endocrinol Investig 34(10):801–810Google Scholar
- 12.Hansen S, Hauge EM, Rasmussen L, Jensen JE, Brixen K (2012) Parathyroidectomy improves bone geometry and microarchitecture in female patients with primary hyperparathyroidism: a one-year prospective controlled study using high-resolution peripheral quantitative computed tomography. J Bone Miner Res 27(5):1150–1158CrossRefGoogle Scholar
- 20.Lourenco DJ, Coutinho FL, Toledo RA, Montenegro FL, Correia-Deur JE, Toledo SP (2010) Early-onset, progressive, frequent, extensive, and severe bone mineral and renal complications in multiple endocrine neoplasia type 1-associated primary hyperparathyroidism. J Bone Miner Res 25(11):2382–2391CrossRefGoogle Scholar
- 21.Yu W, Qin MW, Xu L (1996) Bone mineral analysis of 445 normal subjects assessed by dual X-ray absorptiometry. Chin J Rad 30:625–629Google Scholar
- 27.De Lucia F, Minisola S, Romagnoli E et al (2013) Effect of gender and geographic location on the expression of primary hyperparathyroidism. J Endocrinol Investig 36(2):123–126Google Scholar
- 28.Kann PH, Bartsch D, Langer P et al (2012) Peripheral bone mineral density in correlation to disease-related predisposing conditions in patients with multiple endocrine neoplasia type 1. J Endocrinol Investig 35(6):573–579Google Scholar