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November 1987

What Is the Clinical Significance of Bone Loss in Primary Hyperparathyroidism?

Author Affiliations

From the Division of Geriatrics, Departments of Medicine (Drs Kochersberger, Studenski, and Lyles), Radiology (Drs Martinez and Vogler), and Surgery (Drs Buckley and Leight), Duke University Medical Center, Durham, NC, and the Geriatric Research, Education, and Clinical Center (Drs Kochersberger and Lyles), Durham (NC) Veterans Administration (VA) Medical Center.

Arch Intern Med. 1987;147(11):1951-1953. doi:10.1001/archinte.1987.00370110079012

• To help determine the clinical significance of the bone loss associated with primary hyperparathyroidism, we studied the prevalence of vertebral fractures in a group of patients with this disorder. From a registry of parathyroidectomies, 206 cases were reviewed, and lateral chest roentgenograms were studied for the presence of fractures. All roentgenograms were interpreted by two of the investigators who were "blinded" to diagnoses. Comparisons of readings were made that assured interrater agreement. A group of patients who underwent cholecystectomy served as controls. Studied in a logistic regression analysis model, controlling for the effects of age, sex, and race, primary hyperparathyroidism was found to be significantly associated with vertebral fractures. Subgroup analyses performed on the patients with hyperparathyroidism failed to identify specific biochemical or clinical markers associated with fractures. Our results suggest that the bone loss of primary hyperparathyroidism is clinically significant, leading not only to decreased bone densities but also to an increased prevalence of fractures.

(Arch Intern Med 1987;147:1951-1953)