Section of Endocrinology, Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA.
Oncologist. 2012;17(3):322-5. doi: 10.1634/theoncologist.2011-0285. Epub 2012 Jan 18.
Primary hyperparathyroidism (PHPT) leads to increased bone turnover, low bone mineral density, and increased fracture risk. These effects are, however, preferentially seen in the distal forearm, which is rich in cortical bone. This study aimed to determine how frequently the distal forearm T score was the worst T score and if this T score alone led to higher rate of diagnosis of osteopenia or osteoporosis.
We retrospectively reviewed a prospective database of 300 patients undergoing parathyroidectomy at our institution between November 2000 and January 2009. The bone mineral density of the lumbar spine, total proximal femurs, and distal third of the nondominant radius was measured by dual x-ray absorptiometry. Data on bone density are reported as T scores.
The mean T scores were -1.30 ± 0.2 in the distal forearm, -1.0 ± 0.1 in the total proximal femurs, and -0.9 ± 0.1 in the spine. The distal forearm T score was the worst bone mineral density T score in 39% of patients. This T score alone led to an upstaging in diagnosis to osteopenia or osteoporosis in 9.4% of patients.
In patients with PHPT, the worst T score is commonly found in the distal forearm. This T score can identify additional patients with a diagnosis of osteopenia or osteoporosis. Distal forearm bone mineral density should, therefore, be assessed in all patients who have a diagnosis of PHPT.
原发性甲状旁腺功能亢进症（PHPT）导致骨转换增加、骨密度降低和骨折风险增加。然而，这些影响主要见于富含皮质骨的远端前臂。本研究旨在确定远端前臂 T 评分是否最常是最差 T 评分，以及仅该 T 评分是否会导致更高的骨质疏松或骨量减少诊断率。
我们回顾性分析了 2000 年 11 月至 2009 年 1 月期间在我院接受甲状旁腺切除术的 300 例患者的前瞻性数据库。通过双能 X 线吸收法测量腰椎、全股骨近端和非优势桡骨远端三分之一的骨密度。骨密度数据以 T 评分报告。
远端前臂的平均 T 评分为-1.30 ± 0.2，全股骨近端为-1.0 ± 0.1，脊柱为-0.9 ± 0.1。39%的患者中，远端前臂 T 评分是最差的骨密度 T 评分。仅该 T 评分导致 9.4%的患者诊断为骨质疏松或骨量减少。
在 PHPT 患者中，最差 T 评分通常见于远端前臂。该 T 评分可识别出更多诊断为骨质疏松或骨量减少的患者。因此，所有诊断为 PHPT 的患者都应评估远端前臂的骨密度。
