Skeletal Microstructure and Estimated Bone Strength Improve Following Parathyroidectomy in Primary Hyperparathyroidism

High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure and strength. In asymptomatic primary hyperparathyroidism (PHPT), HRpQCT imaging has demonstrated both decreased cortical and trabecular indi...

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Published inThe journal of clinical endocrinology and metabolism Vol. 103; no. 1; pp. 196 - 205
Main Authors Cusano, Natalie E, Rubin, Mishaela R, Silva, Barbara C, Tay, Yu-Kwang Donovan, Williams, John M, Agarwal, Sanchita, Omeragic, Beatriz, Guo, X Edward, Bilezikian, John P
Format Journal Article
LanguageEnglish
Published United States Copyright Oxford University Press 01.01.2018
Oxford University Press
Endocrine Society
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Abstract High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure and strength. In asymptomatic primary hyperparathyroidism (PHPT), HRpQCT imaging has demonstrated both decreased cortical and trabecular indices, consistent with evidence for increased fracture risk. There are limited data regarding changes in HRpQCT parameters postparathyroidectomy. To evaluate changes in skeletal microstructure by HRpQCT in subjects with PHPT after parathyroidectomy. We studied 29 subjects with PHPT (21 women, 8 men) with HRpQCT at baseline and 6, 12, 18, and 24 months postparathyroidectomy. Volumetric bone mineral density, microarchitectural indices, and finite element analysis at the distal radius and tibia. At both the radius and tibia, there were significant improvements in total, cortical, and trabecular volumetric bone density as early as 6 months postparathyroidectomy (24-month values for total volumetric bone density, radius: +2.8 ± 4%, tibia: +4.4 ± 4%; P < 0.0001 for both), cortical thickness (radius: +1.1 ± 2%, tibia: +2.0 ± 3%; P < 0.01 for both), and trabecular bone volume (radius: +3.8 ± 5%, tibia: +3.2 ± 4%; P < 0.0001 for both). At both sites, by finite element analysis, stiffness and failure load were improved starting at 6 months postparathyroidectomy (24-month values for failure load, radius: +6.2 ± 6%, tibia: +4.8 ± 7%; P < 0.0001 for both). These results provide information about skeletal microarchitecture in subjects with PHPT followed through 2 years after parathyroidectomy. Estimated bone strength is improved, consistent with data showing decreased fracture risk postparathyroidectomy.
AbstractList High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure and strength. In asymptomatic primary hyperparathyroidism (PHPT), HRpQCT imaging has demonstrated both decreased cortical and trabecular indices, consistent with evidence for increased fracture risk. There are limited data regarding changes in HRpQCT parameters postparathyroidectomy. To evaluate changes in skeletal microstructure by HRpQCT in subjects with PHPT after parathyroidectomy. We studied 29 subjects with PHPT (21 women, 8 men) with HRpQCT at baseline and 6, 12, 18, and 24 months postparathyroidectomy. Volumetric bone mineral density, microarchitectural indices, and finite element analysis at the distal radius and tibia. At both the radius and tibia, there were significant improvements in total, cortical, and trabecular volumetric bone density as early as 6 months postparathyroidectomy (24-month values for total volumetric bone density, radius: +2.8 ± 4%, tibia: +4.4 ± 4%; P < 0.0001 for both), cortical thickness (radius: +1.1 ± 2%, tibia: +2.0 ± 3%; P < 0.01 for both), and trabecular bone volume (radius: +3.8 ± 5%, tibia: +3.2 ± 4%; P < 0.0001 for both). At both sites, by finite element analysis, stiffness and failure load were improved starting at 6 months postparathyroidectomy (24-month values for failure load, radius: +6.2 ± 6%, tibia: +4.8 ± 7%; P < 0.0001 for both). These results provide information about skeletal microarchitecture in subjects with PHPT followed through 2 years after parathyroidectomy. Estimated bone strength is improved, consistent with data showing decreased fracture risk postparathyroidectomy.
We report skeletal changes in patients with primary hyperparathyroidism through 2 years after parathyroidectomy using high-resolution imaging.
Context High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure and strength. In asymptomatic primary hyperparathyroidism (PHPT), HRpQCT imaging has demonstrated both decreased cortical and trabecular indices, consistent with evidence for increased fracture risk. There are limited data regarding changes in HRpQCT parameters postparathyroidectomy. Objective To evaluate changes in skeletal microstructure by HRpQCT in subjects with PHPT after parathyroidectomy. Design We studied 29 subjects with PHPT (21 women, 8 men) with HRpQCT at baseline and 6, 12, 18, and 24 months postparathyroidectomy. Main Outcome Measures Volumetric bone mineral density, microarchitectural indices, and finite element analysis at the distal radius and tibia. Results At both the radius and tibia, there were significant improvements in total, cortical, and trabecular volumetric bone density as early as 6 months postparathyroidectomy (24-month values for total volumetric bone density, radius: +2.8 ± 4%, tibia: +4.4 ± 4%; P < 0.0001 for both), cortical thickness (radius: +1.1 ± 2%, tibia: +2.0 ± 3%; P < 0.01 for both), and trabecular bone volume (radius: +3.8 ± 5%, tibia: +3.2 ± 4%; P < 0.0001 for both). At both sites, by finite element analysis, stiffness and failure load were improved starting at 6 months postparathyroidectomy (24-month values for failure load, radius: +6.2 ± 6%, tibia: +4.8 ± 7%; P < 0.0001 for both). Conclusions These results provide information about skeletal microarchitecture in subjects with PHPT followed through 2 years after parathyroidectomy. Estimated bone strength is improved, consistent with data showing decreased fracture risk postparathyroidectomy.
ContextHigh-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure and strength. In asymptomatic primary hyperparathyroidism (PHPT), HRpQCT imaging has demonstrated both decreased cortical and trabecular indices, consistent with evidence for increased fracture risk. There are limited data regarding changes in HRpQCT parameters postparathyroidectomy.ObjectiveTo evaluate changes in skeletal microstructure by HRpQCT in subjects with PHPT after parathyroidectomy.DesignWe studied 29 subjects with PHPT (21 women, 8 men) with HRpQCT at baseline and 6, 12, 18, and 24 months postparathyroidectomy.Main Outcome MeasuresVolumetric bone mineral density, microarchitectural indices, and finite element analysis at the distal radius and tibia.ResultsAt both the radius and tibia, there were significant improvements in total, cortical, and trabecular volumetric bone density as early as 6 months postparathyroidectomy (24-month values for total volumetric bone density, radius: +2.8 ± 4%, tibia: +4.4 ± 4%; P < 0.0001 for both), cortical thickness (radius: +1.1 ± 2%, tibia: +2.0 ± 3%; P < 0.01 for both), and trabecular bone volume (radius: +3.8 ± 5%, tibia: +3.2 ± 4%; P < 0.0001 for both). At both sites, by finite element analysis, stiffness and failure load were improved starting at 6 months postparathyroidectomy (24-month values for failure load, radius: +6.2 ± 6%, tibia: +4.8 ± 7%; P < 0.0001 for both).ConclusionsThese results provide information about skeletal microarchitecture in subjects with PHPT followed through 2 years after parathyroidectomy. Estimated bone strength is improved, consistent with data showing decreased fracture risk postparathyroidectomy.
Author Agarwal, Sanchita
Rubin, Mishaela R
Williams, John M
Bilezikian, John P
Tay, Yu-Kwang Donovan
Omeragic, Beatriz
Cusano, Natalie E
Guo, X Edward
Silva, Barbara C
AuthorAffiliation Department of Medicine, Division of Endocrinology, College of Physicians & Surgeons, Columbia University, New York, New York Department of Medicine, University Center of Belo Horizonte, Belo Horizonte, Brazil Department of Medicine, Santa Casa Hospital, Uberaba, Brazil Department of Medicine, Sengkang Health, Singapore Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York
AuthorAffiliation_xml – name: Department of Medicine, Division of Endocrinology, College of Physicians & Surgeons, Columbia University, New York, New York Department of Medicine, University Center of Belo Horizonte, Belo Horizonte, Brazil Department of Medicine, Santa Casa Hospital, Uberaba, Brazil Department of Medicine, Sengkang Health, Singapore Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York
– name: 1Department of Medicine, Division of Endocrinology, College of Physicians & Surgeons, Columbia University, New York, NY 2Department of Medicine, UNI-BH, and Santa Casa Hospital, Uberaba, 370/705, Belo Horizonte, MG 30180-010, Brazil 3Department of Medicine, Sengkang Health, Singapore 4Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore 5Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York
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Snippet High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure...
Context High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal...
ContextHigh-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal...
We report skeletal changes in patients with primary hyperparathyroidism through 2 years after parathyroidectomy using high-resolution imaging.
SourceID pubmedcentral
proquest
crossref
pubmed
wolterskluwer
SourceType Open Access Repository
Aggregation Database
Index Database
Publisher
StartPage 196
SubjectTerms Adult
Aged
Aged, 80 and over
Bone Density
Bone mineral density
Bone strength
Cancellous bone
Clinical s
Cohort Studies
Computed tomography
Cortical bone
Female
Finite Element Analysis
Finite element method
Follow-Up Studies
Fractures
Fractures, Bone - prevention & control
Humans
Hyperparathyroidism
Hyperparathyroidism, Primary - diagnostic imaging
Hyperparathyroidism, Primary - pathology
Hyperparathyroidism, Primary - surgery
Male
Middle Aged
Parathyroidectomy
Prognosis
Radius
Tibia
Tomography, X-Ray Computed - methods
Title Skeletal Microstructure and Estimated Bone Strength Improve Following Parathyroidectomy in Primary Hyperparathyroidism
URI http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00004678-201801000-00023
https://www.ncbi.nlm.nih.gov/pubmed/29069380
https://www.proquest.com/docview/2364243099
https://search.proquest.com/docview/1956095313
https://pubmed.ncbi.nlm.nih.gov/PMC5761496
Volume 103
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