García-Rueda S, Márquez-Arrico C-F, Herrero-Babiloni A, Silvestre-Rangil J, Silvestre F-J
University of Valencia, c/Gascó Oliag nº1 Valencia, ZIP:46010, Spain
Med Oral Patol Oral Cir Bucal. 2025 Jan 1;30(1):e151-e159. doi: 10.4317/medoral.26958.
Normocalcemic Primary Hyperparathyroidism (NPHPT) is a complex syndrome that causes excess secretion of parathyroid hormone (PTH) from the parathyroid glands. PTH in bone activates the function of osteoclasts, to increase bone resorption and thus increase plasma calcium levels. Given that periodontitis generates osteolytic lesions and has a high prevalence in adults, both pathologies could share etiopathogenic mechanisms, although no studies have been found to date that have investigated this. Therefore, the aim of the study was to evaluate the bone density, periodontal status and biochemistry variables to determinate if there is a relationship between both pathologies.
A case-control study was carried out with 86 cases (NPHPT) and 87 controls. Bone density was evaluated through computed tomography, measured in Hounsfield units, in seven Regions of Interest. Periodontal status and biochemical variables, such as marker hormones of bone metabolism (25 OH vitamin D and PTH), were analyzed. A Student's t test, bivariate correlations were performed and the OR was calculated.
NPHPT patients are more susceptible to changes in the pattern of bone remodeling due to elevated serum levels of PTH and a decrease in 25OH vitamin D under conditions of normocalcemia. The 58.9% of cases group had periodontitis Stage IV, 27% Stage III, 9.45% Stage II and 8.1% with Stage I. Control group showed a 32% periodontitis Stage IV, 39% Stage III, 8.82% have Stage II and 16.2% Stage I.
There was an association between NPHPT and periodontitis, with patients with NPHPT showing a 1.78 (OR) greater probability of suffering from periodontitis. Our biochemical results showed that the increase in PTH and the decrease in 25OH VIT-D were associated with loss of bone density and these patients presented advanced periodontitis.
血钙正常的原发性甲状旁腺功能亢进症（NPHPT）是一种复杂的综合征，可导致甲状旁腺分泌过多的甲状旁腺激素（PTH）。骨骼中的PTH可激活破骨细胞的功能，增加骨吸收，从而提高血浆钙水平。鉴于牙周炎会产生溶骨性病变且在成年人中患病率较高，尽管目前尚未发现有研究对此进行调查，但这两种病症可能具有共同的病因发病机制。因此，本研究的目的是评估骨密度、牙周状况和生化变量，以确定这两种病症之间是否存在关联。
进行了一项病例对照研究，其中有86例病例（NPHPT）和87例对照。通过计算机断层扫描评估骨密度，以亨氏单位在七个感兴趣区域进行测量。分析了牙周状况和生化变量，如骨代谢的标志物激素（25-羟基维生素D和PTH）。进行了学生t检验、双变量相关性分析并计算了比值比（OR）。
在血钙正常的情况下，由于血清PTH水平升高和25-羟基维生素D水平降低，NPHPT患者更容易出现骨重塑模式的改变。病例组中58.9%为IV期牙周炎，27%为III期，9.45%为II期，8.1%为I期。对照组中IV期牙周炎占32%，III期占39%，II期占8.82%，I期占16.2%。
NPHPT与牙周炎之间存在关联，NPHPT患者患牙周炎的可能性高出1.78倍（OR）。我们的生化结果表明，PTH升高和25-羟基维生素D降低与骨密度降低有关，且这些患者患有晚期牙周炎。
