Prevalence of Primary Hyperparathyroidism and Impact on Bone Mineral Density in Elderly Men: MrOs Sweden

• Published in: World journal of surgery Vol. 35; no. 6; pp. 1266 - 1272
• Main Authors: Siilin, Helene, Lundgren, Ewa, Mallmin, Hans, Mellström, Dan, Ohlsson, Claes, Karlsson, Magnus, Orwoll, Eric, Ljunggren, Östen
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.06.2011; Springer‐Verlag; Springer; John Wiley & Sons, Inc
• Subjects: 80 and over; Abdominal Surgery; Absorptiometry; Absorptiometry, Photon; Age Distribution; Aged; Aged, 80 and over; Biological and medical sciences; Bone Density; Bone Density - physiology; Bone Mineral Density; Calcium Homeostasis; Cardiac Surgery; Clinical Medicine; Cohort Studies; diagnosis; Endocrinology and Diabetes; Endocrinopathies; Endokrinologi och diabetes; epidemiology; Female; Femoral Neck; Fractures; Fractures, Spontaneous - diagnosis; Fractures, Spontaneous - epidemiology; General aspects; General Surgery; Geriatric Assessment; Humans; Hyperparathyroidism; Hyperparathyroidism, Primary - diagnosis; Hyperparathyroidism, Primary - epidemiology; Investigative techniques, diagnostic techniques (general aspects); Kirurgi; Klinisk medicin; Male; Medical and Health Sciences; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Medicine & Public Health; metabolism; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Osteoarticular system. Muscles; Osteoporosis; Osteoporosis - diagnosis; Osteoporosis - epidemiology; Parathyroid Hormone; Parathyroid Hormone - metabolism; Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases); Photon; physiology; Prevalence; Primary; Primary Hyperparathyroidism; Prognosis; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Reference Values; Risk Assessment; Severity of Illness Index; Spontaneous; Surgery; Sweden; Sweden - epidemiology; Thoracic Surgery; Vascular Surgery; Weak Negative Correlation; Sweden; Europe; Bone Mineral Density; Calcium Homeostasis; Weak Negative Correlation; Primary Hyperparathyroidism; Femoral Neck; Endocrinopathy; Human; Prevalence; Male; Morbidity; Medicine; Treatment; Parathyroid diseases; Surgery; Primary; Adult; Bone mineral density; Elderly; Hyperparathyroidism
• ISSN: 0364-2313; 1432-2323; 1432-2323
• DOI: 10.1007/s00268-011-1062-2

Background Age and sex are of importance in the development of primary hyperparathyroidism (PHPT), and the disease is most common in postmenopausal women. Skeletal complications are well known at an advanced stage of PHPT, although the impact on bone mineral density (BMD) is evident in patients with mild disease. This study examines the prevalence of PHPT in elderly men and its impact on BMD. Methods Calcium homeostasis and BMD, measured by dual X-ray absorptiometry, were evaluated in 3014 men ages 69 to 81 years in the MrOS-Sweden cohort. Individuals with a low glomerular filtration rate (<21 ml/min/1.73 m 2 ) and vitamin D deficiency (<50 nmol/l) were excluded. Among the remaining subjects, PHPT was assumed in subjects with above-normal albumin-adjusted serum (s)-calcium and plasma intact parathyroid hormone (p-iPTH) levels (PHPT group). BMD was compared between the PHPT group and men without PHPT. Subjects with inappropriately elevated iPTH (IEP group), based on both s-calcium (2.34 mmol/l) and iPTH (4.24 pmol/l) levels being above the median level, were compared to the rest of the cohort. Results The prevalence of PHPT was estimated to be 0.73%. The mean BMD in the total hip and femoral neck was lower in the PHPT group than in the PHPT controls. Significantly lower BMD ( p  < 0.05) was seen in the IEP group (total hip and lumbar spine). Conclusions Elderly men appear to have a lower prevalence of PHPT than women at the same age. The impact of disturbed calcium homeostasis on BMD was also evident in this population group.