Vodopivec Danica M, Silva Angelica M, Garcia-Banigan Dinamarie C, Christakis Ioannis, Stewart Ashley, Schwarz Kelly, Hussey Caroline S, Bassett Roland, Hu Mimi I, Perrier Nancy D
Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas.
Department of Endocrinology Lahey Hospital & Medical Center Burlington Massachusetts.
Endocrinol Diabetes Metab. 2018 Sep 4;1(4):e00037. doi: 10.1002/edm2.37. eCollection 2018 Oct.
Primary hyperparathyroidism reduces bone mineral density, which increases the risk of fracture.
To investigate differences in bone mineral density and clinical characteristics after parathyroidectomy between men and women (premenopausal and postmenopausal) with sporadic primary hyperparathyroidism.
This is a retrospective study of adult patients who underwent parathyroidectomy in a tertiary referral center from 1990 to 2013.
A total of 1529 patients underwent parathyroidectomy during the study period; 80 patients met the inclusion criteria. Of these, 24 were men and 56 were women (10 premenopausal and 46 postmenopausal).
Demographics, preoperative and postoperative biochemical analysis, preoperative and postoperative -scores, preoperative -scores, preoperative and postoperative absolute bone mineral density values, and percentage change in bone mineral density from baseline to 12 ± 6 months after parathyroidectomy in the lumbar spine, femoral neck, total hip and distal one-third of the nondominant radius.
Preoperative 24-hour urinary calcium levels were significantly higher in men than in women overall ( = 0.02) and postmenopausal women ( = 0.01). Men had significantly lower preoperative scores than women overall, premenopausal women and postmenopausal women. Men had greater percentage change of increase in bone mineral density in the femoral neck than did women overall (2.77%; = 0.04) and postmenopausal women (2.98%; = 0.03) 1 year after parathyroidectomy.
From this study, men demonstrated a greater improvement of bone mineral density in the femoral neck from baseline after parathyroidectomy compared with women.
原发性甲状旁腺功能亢进会降低骨密度，从而增加骨折风险。
研究散发性原发性甲状旁腺功能亢进的男性和女性（绝经前和绝经后）患者甲状旁腺切除术后骨密度及临床特征的差异。
这是一项对1990年至2013年在一家三级转诊中心接受甲状旁腺切除术的成年患者的回顾性研究。
研究期间共有1529例患者接受了甲状旁腺切除术；80例患者符合纳入标准。其中，男性24例，女性56例（绝经前10例，绝经后46例）。
人口统计学资料、术前和术后生化分析、术前和术后T评分、术前Z评分、术前和术后绝对骨密度值，以及甲状旁腺切除术后12±6个月腰椎、股骨颈、全髋和非优势侧桡骨远端三分之一处骨密度相对于基线的百分比变化。
总体而言，男性术前24小时尿钙水平显著高于女性（P = 0.02），在绝经后女性中也是如此（P = 0.01）。男性术前T评分显著低于总体女性、绝经前女性和绝经后女性。甲状旁腺切除术后1年，男性股骨颈骨密度增加的百分比变化大于总体女性（2.77%；P = 0.04）和绝经后女性（2.98%；P = 0.03）。
本研究表明，与女性相比，男性甲状旁腺切除术后股骨颈骨密度相对于基线的改善更大。
