Natalie E Cusano1, Mishaela R Rubin1, Barbara C Silva2,3, Yu-Kwang Donovan Tay1,4,5, John M Williams1, Sanchita Agarwal1, Beatriz Omeragic1, X Edward Guo6, John P Bilezikian1. 1. Department of Medicine, Division of Endocrinology, College of Physicians & Surgeons, Columbia University, New York, New York. 2. Department of Medicine, University Center of Belo Horizonte, Belo Horizonte, Brazil. 3. Department of Medicine, Santa Casa Hospital, Uberaba, Brazil. 4. Department of Medicine, Sengkang Health, Singapore. 5. Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore. 6. Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York.
Abstract
Context: High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure and strength. In asymptomatic primary hyperparathyroidism (PHPT), HRpQCT imaging has demonstrated both decreased cortical and trabecular indices, consistent with evidence for increased fracture risk. There are limited data regarding changes in HRpQCT parameters postparathyroidectomy. Objective: To evaluate changes in skeletal microstructure by HRpQCT in subjects with PHPT after parathyroidectomy. Design: We studied 29 subjects with PHPT (21 women, 8 men) with HRpQCT at baseline and 6, 12, 18, and 24 months postparathyroidectomy. Main Outcome Measures: Volumetric bone mineral density, microarchitectural indices, and finite element analysis at the distal radius and tibia. Results: At both the radius and tibia, there were significant improvements in total, cortical, and trabecular volumetric bone density as early as 6 months postparathyroidectomy (24-month values for total volumetric bone density, radius: +2.8 ± 4%, tibia: +4.4 ± 4%; P < 0.0001 for both), cortical thickness (radius: +1.1 ± 2%, tibia: +2.0 ± 3%; P < 0.01 for both), and trabecular bone volume (radius: +3.8 ± 5%, tibia: +3.2 ± 4%; P < 0.0001 for both). At both sites, by finite element analysis, stiffness and failure load were improved starting at 6 months postparathyroidectomy (24-month values for failure load, radius: +6.2 ± 6%, tibia: +4.8 ± 7%; P < 0.0001 for both). Conclusions: These results provide information about skeletal microarchitecture in subjects with PHPT followed through 2 years after parathyroidectomy. Estimated bone strength is improved, consistent with data showing decreased fracture risk postparathyroidectomy.
Context: High-resolution peripheral quantitative computed tomography (HRpQCT) is a noninvasive imaging technology that can provide insight into skeletal microstructure and strength. In asymptomatic primary hyperparathyroidism (PHPT), HRpQCT imaging has demonstrated both decreased cortical and trabecular indices, consistent with evidence for increased fracture risk. There are limited data regarding changes in HRpQCT parameters postparathyroidectomy. Objective: To evaluate changes in skeletal microstructure by HRpQCT in subjects with PHPT after parathyroidectomy. Design: We studied 29 subjects with PHPT (21 women, 8 men) with HRpQCT at baseline and 6, 12, 18, and 24 months postparathyroidectomy. Main Outcome Measures: Volumetric bone mineral density, microarchitectural indices, and finite element analysis at the distal radius and tibia. Results: At both the radius and tibia, there were significant improvements in total, cortical, and trabecular volumetric bone density as early as 6 months postparathyroidectomy (24-month values for total volumetric bone density, radius: +2.8 ± 4%, tibia: +4.4 ± 4%; P < 0.0001 for both), cortical thickness (radius: +1.1 ± 2%, tibia: +2.0 ± 3%; P < 0.01 for both), and trabecular bone volume (radius: +3.8 ± 5%, tibia: +3.2 ± 4%; P < 0.0001 for both). At both sites, by finite element analysis, stiffness and failure load were improved starting at 6 months postparathyroidectomy (24-month values for failure load, radius: +6.2 ± 6%, tibia: +4.8 ± 7%; P < 0.0001 for both). Conclusions: These results provide information about skeletal microarchitecture in subjects with PHPT followed through 2 years after parathyroidectomy. Estimated bone strength is improved, consistent with data showing decreased fracture risk postparathyroidectomy.
Authors: M Parisien; R W Mellish; S J Silverberg; E Shane; R Lindsay; J P Bilezikian; D W Dempster Journal: J Bone Miner Res Date: 1992-08 Impact factor: 6.741
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Authors: Gabrielle K Steinl; Randy Yeh; Marcella D Walker; Catherine McManus; James A Lee; Jennifer H Kuo Journal: Bone Date: 2021-02-02 Impact factor: 4.626