Skeletal health status among patients with chronic hypoparathyroidism: results from the Canadian National Hypoparathyroidism Registry (CNHR).

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Osteoporosis International Pub Date : 2025-02-16 DOI:10.1007/s00198-025-07410-7

Aliya A Khan, Hajar AbuAlrob, Dalal S Ali, Zayd Al Kassem, Abdulrahman Almoulia, Habiba Afifi, Manoela Braga, Alice Cheng, Jouma Malhem, Adam Millar, Emmett Morgante, Parwana Muhammad, Terri L Paul, Ally Prebtani, Zubin Punthakee, Tayyab Khan, Sarah Khan, Muhammad Shrayyef, Stan Van Uum, James Edward Massey Young, Maria Luisa Brandi, Michel Ovize, Blandine Weiss

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引用次数: 0

Abstract

In the CNHR study, 35% of postmenopausal women had osteoporosis by BMD or fragility fracture, and 4% had both. Three men ≥ 50 had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This suggests that close follow-up of skeletal health is necessary in postmenopausal women, and men ≥ 50 with chronic HypoPT.

Purpose: Chronic hypoparathyroidism (HypoPT) has been associated with decreased bone turnover and abnormalities in bone mineral density (BMD), microarchitecture, and strength. Current guidelines do not recommend systematic evaluation of skeletal health in patients with chronic HypoPT. Our study assessed skeletal health in pre- and postmenopausal women with chronic HypoPT and adult men.

Methods: This prospective study enrolled adults with chronic HypoPT from the Canadian National Hypoparathyroidism Registry. Clinical characteristics, bone fractures, biochemistry, and serum bone biomarkers were assessed at baseline. Skeletal health evaluation included assessments of fragility fractures, BMD at lumbar spine (LS), femoral neck (FN), total hip (TH), 1/3 radial sites, trabecular bone score (TBS), and bone biomarkers.

Results: We present the baseline data of the patients enrolled in the registry. We analyzed a total of 101 patients: 18 men, 35 premenopausal, and 48 postmenopausal women. The mean (SD) age at the onset of HypoPT was 40.7 (16.8) years, and the average disease duration was 11.2 (8.6) years. The most common etiology was postsurgical (74.3% vs. 25.7% non-surgical). Most patients received calcium supplements (89%) and active vitamin D (80%) at baseline. No fragility fractures or low BMD were reported in premenopausal women. However, BMD at LS, FN, TH, and TBS were significantly lower in postmenopausal compared to premenopausal women.

Conclusions: Overall, 35% of postmenopausal women had osteoporosis by BMD or prior fragility fracture, and 4% had both. Three men ≥ 50 years had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This study suggests that close follow-up of skeletal health is necessary in postmenopausal women with chronic HypoPT and men ≥ 50 years.

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慢性甲状旁腺功能减退患者的骨骼健康状况：来自加拿大国家甲状旁腺功能减退登记处（CNHR）的结果

在CNHR的研究中，35%的绝经后妇女患有骨质疏松症或脆性骨折，4%的妇女两者兼有。3名≥50岁男性有骨质疏松症（骨密度或脆性骨折）(33.3%；n = 3/9)。这表明对绝经后女性和≥50岁的慢性HypoPT患者进行骨骼健康的密切随访是必要的。目的：慢性甲状旁腺功能减退症（HypoPT）与骨转换减少、骨矿物质密度（BMD）、微结构和强度异常有关。目前的指南不建议对慢性HypoPT患者进行骨骼健康的系统评估。我们的研究评估了患有慢性HypoPT的绝经前和绝经后女性以及成年男性的骨骼健康状况。方法：这项前瞻性研究招募了来自加拿大国家甲状旁腺功能减退症登记处的慢性hypoopt成人患者。在基线时评估临床特征、骨折、生物化学和血清骨生物标志物。骨骼健康评估包括脆弱性骨折、腰椎（LS）、股骨颈（FN）、全髋关节（TH）、1/3桡骨部位、骨小梁评分（TBS）和骨生物标志物的评估。结果：我们提供了登记入组患者的基线数据。我们总共分析了101例患者：18例男性，35例绝经前女性，48例绝经后女性。HypoPT发病的平均（SD）年龄为40.7（16.8）岁，平均病程为11.2（8.6）年。最常见的病因是术后（74.3% vs. 25.7%非手术）。大多数患者在基线时接受钙补充剂（89%）和活性维生素D（80%）。绝经前妇女无脆性骨折或低骨密度报告。然而，与绝经前妇女相比，绝经后妇女LS、FN、TH和TBS的骨密度显著降低。结论：总体而言，35%的绝经后妇女患有骨质疏松症或既往脆性骨折，4%两者兼有。3名≥50岁男性有骨质疏松症（骨密度或脆性骨折）(33.3%；n = 3/9)。这项研究表明，对绝经后患有慢性HypoPT的女性和年龄≥50岁的男性进行骨骼健康的密切随访是必要的。

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来源期刊

Osteoporosis International 医学-内分泌学与代谢

CiteScore

8.10

自引率

10.00%

发文量

224

审稿时长

3 months

期刊介绍： An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.