Operative intervention for primary hyperparathyroidism offers greater bone recovery in patients with sporadic disease than in those with multiple endocrine neoplasia type 1-related hyperparathyroidism

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• 作者：Angelica M. Silva ; MD^a ; Danica Vodopivec ; MD^a ; Ioannis Christakis ; MD^a ; Genevieve Lyons ; MSPH^b ; Qiu Wei ; MD^a ; Steven G. Waguespack ; MD^c ; Steven M. Petak ; MD^c ; Elizabeth Grubbs ; MD^a ; Jeffrey E. Lee ; MD^a ; Nancy Perrier ; MD^a ; ^{nperrier@mdanderson.org}
• 刊名：Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：161
• 期：1
• 页码：107-115
• 全文大小：493 K
• 卷排序：161

文摘

We investigated whether the outcome of bone disease of primary hyperparathyroidism differs in multiple endocrine neoplasia type 1–associated disease and sporadic hyperparathyroidism at 1-year postoperatively.MethodsMultiple endocrine neoplasia type 1/hyperparathyroidism and sporadic hyperparathyroidism patients who underwent parathyroidectomy from 1990 to 2013 and dual-energy x-ray absorptiometry at baseline and 1-year postoperatively were included. Preoperative and postoperative dual-energy x-ray absorptiometry measurements (bone mineral density and Z-score at the lumbar spine, total hip, and femoral neck) were analyzed.ResultsWe evaluated 14 multiple endocrine neoplasia type 1/hyperparathyroidism and 104 sporadic hyperparathyroidism patients. The preoperative Z-scores at the lumbar spine, total hip, and femoral neck were lower in the multiple endocrine neoplasia type 1/hyperparathyroidism group (P = .05, P = .04, and P = .0081, respectively). Comparison of preoperative and postoperative dual-energy x-ray absorptiometry measurements demonstrated that the multiple endocrine neoplasia type 1/hyperparathyroidism group had a significantly higher Z-score at the lumbar spine (P = .02) at 1 year after operation, whereas the sporadic hyperparathyroidism group had a significantly higher Z-score at the lumbar spine, total hip, and femoral neck (P < .0001, P = .0004, and P = .0001) and higher bone mineral density at the lumbar spine (P = .0001).ConclusionLong-term monitoring of these patients using dual-energy x-ray absorptiometry is required to assess outcomes and facilitate decisions on the timing of operative intervention.