Mahdavizadeh Vahid, Emadzadeh Maryam, Mazloum Khorasani Zahra
Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Arch Bone Jt Surg. 2025;13(3):125-133. doi: 10.22038/ABJS.2025.82946.3775.
This study aimed to analyze the prevalence of osteopenia and osteoporosis in MEN1-related primary hyperparathyroidism (PHPT), examine the impact of parathyroidectomy (PTX) on bone metabolic outcomes, and compare bone density metrics between sporadic and MEN1-related PHPT.
A systematic review and meta-analysis were conducted in accordance with the guidelines for Meta-Analyses and Systematic Reviews of Observational Studies (MOOSE). We searched PubMed, Web of Science, and Scopus up to June 2024, subsequently screening the articles to identify relevant research. Studies focusing on bone mineral density (BMD), T and Z-scores in patients with MEN1-related conditions were included. Meta-analyses were conducted using random-effects models.
From the initial 2,563 articles, 15 studies were included in the meta-analysis. The pooled prevalence of osteoporosis and osteopenia in patients with MEN1-related PHPT was 45.2% (95% CI: 39.1-51.4%; I2: 16.7%) and 53.3% (95% CI: 44.4-62.0%; I2: 36.15%), respectively. PTX showed no significant impact on BMD in MEN1-related PHPT patients at the lumbar spine (mean difference: -0.054; P-value = 0.092; I2: 0.86%) or femoral neck (mean difference: -0.025; P-value = 0.219; I2: 0.47%). Comparisons of bone density metrics showed that MEN1-related PHPT patients had significantly lower Z-scores at the lumbar spine (mean difference: -0.676; P-value < 0.001; I2: 41.86%), total hip (mean difference: -0.629; P < 0.001; I2: 23.4%), and femoral neck (mean difference: -0.516; P < 0.001; I2 = 38.82%) compared to patients with sporadic PHPT.
Patients with MEN1-related PHPT exhibited a high prevalence of osteopenia and osteoporosis, along with lower BMD metrics compared to those with sporadic PHPT. PTX was not associated with significant changes in BMD among MEN1-related PHPT patients.
本研究旨在分析MEN1相关原发性甲状旁腺功能亢进症（PHPT）中骨质减少和骨质疏松症的患病率，研究甲状旁腺切除术（PTX）对骨代谢结果的影响，并比较散发性和MEN1相关PHPT之间的骨密度指标。
根据观察性研究的Meta分析和系统评价指南（MOOSE）进行系统评价和Meta分析。我们检索了截至2024年6月的PubMed、科学网和Scopus，随后筛选文章以确定相关研究。纳入关注MEN1相关疾病患者骨矿物质密度（BMD）、T值和Z值的研究。使用随机效应模型进行Meta分析。
从最初的2563篇文章中，15项研究纳入了Meta分析。MEN1相关PHPT患者骨质疏松症和骨质减少症的合并患病率分别为45.2%（95%CI：39.1-51.4%；I2：16.7%）和53.3%（95%CI：44.4-62.0%；I2：36.15%）。PTX对MEN1相关PHPT患者腰椎的BMD（平均差异：-0.054；P值=0.092；I2：0.86%）或股骨颈的BMD（平均差异：-0.025；P值=0.219；I2：0.47%）无显著影响。骨密度指标比较显示，与散发性PHPT患者相比，MEN1相关PHPT患者腰椎（平均差异：-0.676；P值<0.001；I2：41.86%）、全髋（平均差异：-0.629；P<0.001；I2：23.4%）和股骨颈（平均差异：-0.516；P<0.001；I2=38.82%）的Z值显著更低。
与散发性PHPT患者相比，MEN1相关PHPT患者骨质减少和骨质疏松症的患病率较高，且BMD指标较低。PTX与MEN1相关PHPT患者的BMD显著变化无关。
