Vertebral Fracture Assessment in Postmenopausal Women With Postsurgical Hypoparathyroidism

• Published in: The journal of clinical endocrinology and metabolism Vol. 106; no. 5; pp. 1303 - 1311
• Main Authors: Cipriani, Cristiana, Minisola, Salvatore, Bilezikian, John P, Diacinti, Davide, Colangelo, Luciano, Piazzolla, Valentina, Angelozzi, Maurizio, Nieddu, Luciano, Pepe, Jessica, Diacinti, Daniele
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.05.2021
• Subjects: Absorptiometry; Absorptiometry, Photon; Aged; Bone Density; Bone mineral density; Bone turnover; Bones; Cancellous bone; Chronic Disease; Clinical s; Cross-Sectional Studies; Density; Dual energy X-ray absorptiometry; Endocrine disorders; Female; Femur Neck; Fractures; Health aspects; Humans; Hypoparathyroidism; Hypoparathyroidism - diagnosis; Hypoparathyroidism - epidemiology; Hypoparathyroidism - etiology; Italy - epidemiology; Lumbar Vertebrae; Middle Aged; Osteoporosis, Postmenopausal - epidemiology; Osteoporotic Fractures - epidemiology; Parathyroid hormone; Parathyroidectomy - adverse effects; Post-menopause; Postmenopausal women; Postmenopause; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prevalence; Spinal Fractures - diagnosis; Spinal Fractures - epidemiology; Spine (lumbar); Vertebrae; Women; Italy; United States > US; VFA; hypoparathyroidism; postmenopausal women; fracture
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgab076

Abstract Context Hypoparathyroidism is a rare endocrine disorder whose skeletal features include suppression of bone turnover and greater volume and width of the trabecular compartment. Few and inconsistent data are available on the prevalence of vertebral fractures (VF). Objective To evaluate the prevalence of VF assessed by vertebral fracture assessment (VFA) in postmenopausal women with chronic postsurgical hypoparathyroidism. Design Cross-sectional study Setting Ambulatory referral center. Patients or Other Participants Fifty postmenopausal women (mean age 65.4 ± 9 years) with chronic postsurgical hypoparathyroidism and 40 age-matched healthy postmenopausal women (mean age 64.2 ± 8.6). Main outcome measures Lumbar spine, femoral neck, and total hip bone mineral density were measured by dual X-ray absorptiometry (Hologic Inc., USA) in all subjects. Site-matched spine trabecular bone score was calculated by TBS iNsight (Medimaps, Switzerland). Assessment of VF was made by VFA (iDXA, Lunar GE, USA) using the semiquantitative method and the algorithm-based qualitative assessment. Results All-site BMD values were higher in the hypoparathyroid vs the control group. By VFA, we observed a 16% prevalence of VF in hypoparathyroid women vs 7.5% in control subjects. Among those with hypoparathyroidism who fractured, 5 (62.5%) had grade 1 wedge, 2 (25%) had grade 2 wedge, and 1 (12.5%) had grade 2 wedge and grade 2 biconcave VF. In the hypoparathyroid group, 57% with VFs and 32% without VFs had symptoms of hypoparathyroidism. Conclusion We demonstrate for the first time that in postmenopausal women with chronic postsurgical hypoparathyroidism, VFs are demonstrable by VFA despite normal BMD.