Effect of parathyroidectomy versus conservative management on bone mineral density in patients with primary hyperparathyroidism.

IF 2.4 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases Pub Date : 2026-03-05 DOI:10.1016/j.anorl.2025.12.004

A Green, K Hardy, O Al-Dadah

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引用次数: 0

Abstract

Background: Hyperparathyroidism stimulates osteoclasts to increase bone resorption, release skeletal calcium, and cause a reduction of bone mass. Parathyroidectomy remains the only curative treatment however medical therapies can also control symptoms and limit osteoporosis. The aim of this study was to compare the impact of parathyroidectomy with medical management on bone mineral density (BMD) in patients with primary hyperparathyroidism.

Methods: An observational study including a total of 82 patients with hyperparathyroidism, comprising the Surgical Group (n=49) and Medical Group (n=33). Patients had BMD assessed at the lumbar spine, hip and forearm using dual-energy X-ray absorptiometry before and after intervention.

Results: At a mean follow-up of 4.3 years, BMD increased in the lumbar spine by +6.8% (P=0.004) in the Surgical Group and +3.1% (P=0.016) in the Medical Group. BMD was recovered or maintained in all regions in the Surgical Group, whereas a decrease of -7.1% (P=0.043) was noted in the forearms of the Medical Group. Significant between-group differences in BMD change favouring the Surgical Group in the total hip (+1.6% vs -1.7%, P=0.019), distal one-third radius (+0.3% vs -7.1%, P=0.045) and ultra-distal radius (+2.0% vs -9.1%, P=0.003). A greater proportion of patients in the Medical Group developed osteopenia or osteoporosis (P<0.001).

Conclusions: This study has demonstrated that BMD improved or was preserved more greatly in patients with primary hyperparathyroidism who underwent parathyroidectomy rather than non-surgical management at 4 years follow-up. Greater BMD preservation in both groups, compared to previous studies, may be explained by greater utilisation of available medical therapies.

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甲状旁腺切除术与保守治疗对原发性甲状旁腺功能亢进患者骨密度的影响。

背景：甲状旁腺功能亢进刺激破骨细胞增加骨吸收，释放骨钙，导致骨量减少。甲状旁腺切除术仍然是唯一的治疗方法，但药物治疗也可以控制症状和限制骨质疏松症。本研究的目的是比较甲状旁腺切除术与药物治疗对原发性甲状旁腺功能亢进患者骨矿物质密度（BMD）的影响。方法：观察性研究共纳入82例甲状旁腺功能亢进患者，其中手术组（n=49）和内科组（n=33）。患者在干预前后使用双能x线骨密度仪评估腰椎、髋关节和前臂的骨密度。结果：平均随访4.3年，手术组腰椎骨密度增加+6.8% (P=0.004)，内科组增加+3.1% （P=0.016）。外科组各部位骨密度均得到恢复或维持，而内科组前臂骨密度下降-7.1% （P=0.043）。手术组在全髋关节（+1.6% vs -1.7%， P=0.019）、桡骨远端（+0.3% vs -7.1%， P=0.045）和桡骨超远端（+2.0% vs -9.1%， P=0.003）的骨密度变化方面存在显著差异。结论：该研究表明，在4年的随访中，接受甲状旁腺切除术而非非手术治疗的原发性甲状旁腺功能亢患者，骨密度得到了更大的改善或保存。与之前的研究相比，两组患者的骨密度都保持得更好，这可能是由于更多地利用了现有的医学疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Annals of Otorhinolaryngology-Head and Neck Diseases OTORHINOLARYNGOLOGY-

CiteScore

3.70

自引率

28.00%

发文量

审稿时长

12 days

期刊介绍： European Annals of Oto-rhino-laryngology, Head and Neck diseases heir of one of the oldest otorhinolaryngology journals in Europe is the official organ of the French Society of Otorhinolaryngology (SFORL) and the the International Francophone Society of Otorhinolaryngology (SIFORL). Today six annual issues provide original peer reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches and review articles giving most up-to-date insights in all areas of otology, laryngology rhinology, head and neck surgery. The European Annals also publish the SFORL guidelines and recommendations.The journal is a unique two-armed publication: the European Annals (ANORL) is an English language well referenced online journal (e-only) whereas the Annales Françaises d’ORL (AFORL), mail-order paper and online edition in French language are aimed at the French-speaking community. French language teams must submit their articles in French to the AFORL site. Federating journal in its field, the European Annals has an Editorial board of experts with international reputation that allow to make an important contribution to communication on new research data and clinical practice by publishing high-quality articles.