Bone health in patients undergoing surgery for primary hyperparathyroidism at Tygerberg Hospital, Cape Town, South Africa
Date
2021-03
Journal Title
Journal ISSN
Volume Title
Publisher
Jemdsa
Abstract
Background: Increased bone resorption is a well-described consequence of primary hyperparathyroidism (PHPT). In South
Africa, little is known about the impact of PHPT on skeletal health.
Objective: To determine the prevalence of decreased bone mineral density (BMD), vertebral fractures and osteitis fibrosa
cystica in patients with PHPT who underwent parathyroidectomy.
Methods: Retrospective study of patients who underwent parathyroidectomy for PHPT at Tygerberg Hospital in Cape Town,
from January 2010 to December 2019. Clinical, biochemical and BMD parameters are described.
Results: Final analysis included 56 patients (median age 63.5 years; 80.4% female). Initial calcium, parathyroid hormone (PTH)
and 25-hydroxyvitamin D (25[OH]D) levels were 2.93 mmol/l, 19.4 pmol/l and 34.0 nmol/l, respectively. Of the total cohort,
71.4% had decreased BMD. The prevalence of osteoporosis and osteopenia in postmenopausal women and men ≥ 50 years
was 50.0% and 39.1% respectively; low bone mass for age in premenopausal women and men < 50 years was 20.0%.
Vertebral fractures were seen in 21.2% of patients on radiography. Osteitis fibrosa cystica was present in five patients
(9.6%). PTH levels were significantly elevated in patients with osteoporosis compared with those with normal BMD (36.4 vs.
16.1 pmol/l; p = 0.02).
Conclusion: Two-thirds of patients who underwent parathyroidectomy for PHPT had decreased BMD, with osteoporosis
present in 50% of postmenopausal women and older men. One in five had vertebral fractures. These findings underscore
the importance of skeletal assessment in the management of PHPT.
Description
CITATION:Budgea, M, et al. 2021. Bone health in patients undergoing surgery for primary hyperparathyroidism at Tygerberg Hospital, Cape Town, South Africa. Journal of Endocrinology, Metabolism and Diabetes of South Africa 26(1):16–23
doi.10.1080/16089677.2020.1843841
The original publication is available at: .jemdsa.co.za
The original publication is available at: .jemdsa.co.za
Keywords
Bone resorption, Bone densitometry, Fractures, Osteoporosis, Parathyroid hormone, Hyperparathyroidism, Calcium, UCTD
Citation
Budgea, M, et al. 2021. Bone health in patients undergoing surgery for primary hyperparathyroidism at Tygerberg Hospital, Cape Town, South Africa. Journal of Endocrinology, Metabolism and Diabetes of South Africa 26(1):16–23
doi.10.1080/16089677.2020.1843841