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Serum parathyroid hormone is associated with increased cortical porosity of the inner transitional zone at the proximal femur in postmenopausal women: the Tromsø Study.
Osteoporos Int 2018; 29(2):421-431OI

Abstract

Serum parathyroid hormone (PTH) was associated with increased bone turnover markers and cortical porosity of the inner transitional zone at the proximal femur. These results suggest that PTH through increased intracortical bone turnover leads to trabecularisation of inner cortical bone in postmenopausal women.

INTRODUCTION

Vitamin D deficiency leads to secondary hyperparathyroidism and increased risk for fractures, whereas its association with cortical porosity is less clear. We tested (i) whether serum 25-hydroxyvitamin D (25(OH)D) and PTH were associated with cortical porosity and (ii) whether the associations of 25(OH)D) and PTH with fracture risk are dependent on cortical porosity.

METHODS

This case-control study included 211 postmenopausal women, 54-94 years old, with prevalent fractures and 232 controls from the Tromsø Study. Serum 25(OH)D, PTH, and bone turnover markers (procollagen type I N-terminal propeptide [PINP] and C-terminal cross-linking telopeptide of type I collagen [CTX]) were measured. Femoral subtrochanteric cortical and trabecular parameters were quantified using computed tomography, and femoral neck areal bone mineral density (FN aBMD) was quantified using dual-energy X-ray absorptiometry.

RESULTS

Compared with controls, fracture cases exhibited reduced serum 25(OH)D and increased PTH, PINP, and CTX, increased femoral subtrochanteric cortical porosity, and reduced cortical thickness and FN aBMD (all, p < 0.05). Serum 25(OH)D was not associated with cortical parameters (all, p > 0.10). PTH was associated with increased PINP, CTX, and cortical porosity of the inner transitional zone and reduced trabecular bone volume/tissue volume and FN aBMD (p ranging from 0.003 to 0.054). Decreasing 25(OH)D and increasing PTH were associated with increased odds for fractures, independent of age, height, weight, calcium supplementation, serum calcium, cortical porosity, and thickness.

CONCLUSIONS

These data suggest that serum PTH, not 25(OH)D, is associated with increased intracortical bone turnover resulting in trabecularisation of the inner cortical bone; nevertheless, decreasing 25(OH)D) and increasing PTH are associated with fracture risk, independent of cortical porosity and thickness.

Authors+Show Affiliations

Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, N-9037, Tromsø, Norway. mos015@uit.no. Department of Orthopaedic Surgery, University Hospital of North Norway, Tromsø, Norway. mos015@uit.no.Department of Rheumatology, Vestre Viken Hospital Trust, Hospital of Drammen, Drammen, Norway.Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, N-9037, Tromsø, Norway.Department of Medicine, University Hospital of North Norway, Tromsø, Norway. Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.Department of Medicine, University Hospital of North Norway, Tromsø, Norway. Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. Institute of Clinical Medicine, University of Oslo, Oslo, Norway.Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway. Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29134242

Citation

Osima, M, et al. "Serum Parathyroid Hormone Is Associated With Increased Cortical Porosity of the Inner Transitional Zone at the Proximal Femur in Postmenopausal Women: the Tromsø Study." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 29, no. 2, 2018, pp. 421-431.
Osima M, Borgen TT, Lukic M, et al. Serum parathyroid hormone is associated with increased cortical porosity of the inner transitional zone at the proximal femur in postmenopausal women: the Tromsø Study. Osteoporos Int. 2018;29(2):421-431.
Osima, M., Borgen, T. T., Lukic, M., Grimnes, G., Joakimsen, R. M., Eriksen, E. F., & Bjørnerem, Å. (2018). Serum parathyroid hormone is associated with increased cortical porosity of the inner transitional zone at the proximal femur in postmenopausal women: the Tromsø Study. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 29(2), pp. 421-431. doi:10.1007/s00198-017-4298-3.
Osima M, et al. Serum Parathyroid Hormone Is Associated With Increased Cortical Porosity of the Inner Transitional Zone at the Proximal Femur in Postmenopausal Women: the Tromsø Study. Osteoporos Int. 2018;29(2):421-431. PubMed PMID: 29134242.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum parathyroid hormone is associated with increased cortical porosity of the inner transitional zone at the proximal femur in postmenopausal women: the Tromsø Study. AU - Osima,M, AU - Borgen,T T, AU - Lukic,M, AU - Grimnes,G, AU - Joakimsen,R M, AU - Eriksen,E F, AU - Bjørnerem,Å, Y1 - 2017/11/14/ PY - 2017/07/12/received PY - 2017/11/01/accepted PY - 2017/11/15/pubmed PY - 2019/2/5/medline PY - 2017/11/15/entrez KW - 25-Hydroxyvitamin D KW - Bone turnover markers KW - Cortical porosity KW - Non-vertebral fracture KW - Parathyroid hormone SP - 421 EP - 431 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 29 IS - 2 N2 - : Serum parathyroid hormone (PTH) was associated with increased bone turnover markers and cortical porosity of the inner transitional zone at the proximal femur. These results suggest that PTH through increased intracortical bone turnover leads to trabecularisation of inner cortical bone in postmenopausal women. INTRODUCTION: Vitamin D deficiency leads to secondary hyperparathyroidism and increased risk for fractures, whereas its association with cortical porosity is less clear. We tested (i) whether serum 25-hydroxyvitamin D (25(OH)D) and PTH were associated with cortical porosity and (ii) whether the associations of 25(OH)D) and PTH with fracture risk are dependent on cortical porosity. METHODS: This case-control study included 211 postmenopausal women, 54-94 years old, with prevalent fractures and 232 controls from the Tromsø Study. Serum 25(OH)D, PTH, and bone turnover markers (procollagen type I N-terminal propeptide [PINP] and C-terminal cross-linking telopeptide of type I collagen [CTX]) were measured. Femoral subtrochanteric cortical and trabecular parameters were quantified using computed tomography, and femoral neck areal bone mineral density (FN aBMD) was quantified using dual-energy X-ray absorptiometry. RESULTS: Compared with controls, fracture cases exhibited reduced serum 25(OH)D and increased PTH, PINP, and CTX, increased femoral subtrochanteric cortical porosity, and reduced cortical thickness and FN aBMD (all, p < 0.05). Serum 25(OH)D was not associated with cortical parameters (all, p > 0.10). PTH was associated with increased PINP, CTX, and cortical porosity of the inner transitional zone and reduced trabecular bone volume/tissue volume and FN aBMD (p ranging from 0.003 to 0.054). Decreasing 25(OH)D and increasing PTH were associated with increased odds for fractures, independent of age, height, weight, calcium supplementation, serum calcium, cortical porosity, and thickness. CONCLUSIONS: These data suggest that serum PTH, not 25(OH)D, is associated with increased intracortical bone turnover resulting in trabecularisation of the inner cortical bone; nevertheless, decreasing 25(OH)D) and increasing PTH are associated with fracture risk, independent of cortical porosity and thickness. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/29134242/Serum_parathyroid_hormone_is_associated_with_increased_cortical_porosity_of_the_inner_transitional_zone_at_the_proximal_femur_in_postmenopausal_women:_the_Tromsø_Study_ L2 - https://dx.doi.org/10.1007/s00198-017-4298-3 DB - PRIME DP - Unbound Medicine ER -