Ohe Monique Nakayama, Bonanséa Teresa Cristina Piscitelli, Santos Rodrigo Oliveira, Neves Murilo Catafesta das, Santos Livia Marcela, Rosano Marcello, Kunii Ilda Sizue, Castro Marise Lazaretti, Vieira José Gilberto Henriques
Departamento de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil.
Departamento de Otorrinolaringologia, Cabeça e Pescoço, EPM-Unifesp, São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2019 Jul 29;63(4):394-401. doi: 10.20945/2359-3997000000154.
To measure type 1 serum amino-terminal propeptide procollagen (P1NP) and type 1 cross-linked C-terminal telopeptide collagen (CTX) before parathyroidectomy (PTX) in PHPT patients, correlating these measurements with bone mineral density (BMD) changes.
31 primary hyperparathyroidism (HPTP) were followed from diagnosis up to 12-18 months after surgery. Serum levels of calcium, parathyroid hormone (PTH) vitamin D, CTX, P1NP, and BMD were measured before and 1 year after surgery.
One year after PTX, the mean BMD increased by 8.6%, 5.5%, 5.5%, and 2.2% in the lumbar spine, femoral neck (FN), total hip (TH), and distal third of the nondominant radius (R33%), respectively. There was a significant correlation between BMD change 1 year after the PTX and CTX (L1-L4: r = 0.614, p < 0.0003; FN: r = 0.497, p < 0.0051; TH: r = 0.595, p < 0.0005; R33%: r = 0.364, p < 0.043) and P1NP (L1-L4: r = 0,687, p < 0,0001; FN: r = 0,533, p < 0,0024; TH: r = 0,642, p < 0,0001; R33%: r = 0,467, p < 0,0079) preoperative levels. The increase in 25(OH)D levels has no correlation with BMD increase (r = -0.135; p = 0.4816). On linear regression, a minimum preoperative CTX value of 0.331 ng/mL or P1NP of 37.9 ng/mL was associated with a minimum 4% increase in L1-L4 BMD. In TH, minimum preoperative values of 0.684 ng/mL for CTX and 76.0 ng/mL for P1NP were associated with a ≥ 4% increase in BMD.
PHPT patients presented a significant correlation between preoperative levels of turnover markers and BMD improvement 1 year after PTX.
测量原发性甲状旁腺功能亢进症（PHPT）患者甲状旁腺切除术（PTX）前的1型血清氨基端前胶原肽（P1NP）和1型交联C端肽胶原蛋白（CTX），并将这些测量值与骨密度（BMD）变化相关联。
对31例原发性甲状旁腺功能亢进症（HPTP）患者从诊断开始随访至术后12 - 18个月。在手术前和术后1年测量血清钙、甲状旁腺激素（PTH）、维生素D、CTX、P1NP和BMD水平。
PTX术后1年，腰椎、股骨颈（FN）、全髋（TH）和非优势侧桡骨远端三分之一处（R33%）的平均BMD分别增加了8.6%、5.5%、5.5%和2.2%。PTX术后1年BMD变化与术前CTX（L1 - L4：r = 0.614，p < 0.0003；FN：r = 0.497，p < 0.0051；TH：r = 0.595，p < 0.0005；R33%：r = 0.364，p < 0.043）和P1NP（L1 - L4：r = 0.687，p < 0.0001；FN：r = 0.533，p < 0.0024；TH：r = 0.642，p < 0.0001；R33%：r = 0.467，p < 0.0079）水平存在显著相关性。25（OH）D水平的升高与BMD增加无相关性（r = -0.135；p = 0.4816）。线性回归分析显示，术前CTX最低值为0.331 ng/mL或P1NP为37.9 ng/mL与L1 - L4 BMD至少增加4%相关。在TH中，术前CTX最低值为0.684 ng/mL和P1NP为76.0 ng/mL与BMD增加≥4%相关。
PHPT患者术前骨转换标志物水平与PTX术后1年BMD改善之间存在显著相关性。
