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Increased biochemical markers of bone formation and resorption in primary hyperparathyroidism with special reference to patients with mild disease.
J Intern Med. 1998 Feb; 243(2):115-22.JI

Abstract

OBJECTIVES

To evaluate the impact on bone turnover of primary hyperparathyroidism (pHPT) with special reference to patients with mild pHPT, using biochemical markers of bone formation and resorption.

DESIGN

A longitudinal study of patients with pHPT before and one year after surgical treatment.

SETTING

The Departments of Internal Medicine and Surgery, Lund University Hospital.

SUBJECTS

Forty consecutive patients with pHPT. Thirty of these patients had mild pHPT and are reported separately. Data on bone mineral was also compared to a reference population.

INTERVENTION

All patients were operated upon and restudied one year later.

MAIN OUTCOME MEASURES

Bone resorption and formation was studied by means of the serum concentrations of the telopeptide of the carboxyterminal region of type 1 collagen (ICTP) and of alkaline phosphatase (ALP), osteocalcin and the carboxyterminal propeptide of type 1 procollagen (PICP), respectively. Bone density was measured at the distal radius by single photon absorptiometry (SPA).

RESULTS

Bone formation markers consistently decreased after parathyroid surgery: ALP from 3.51 +/- 0.23 to 2.94 +/- 0.21 microkat L(-1) (P < 0.05), osteocalcin from 6.15 +/- 0.53 to 2.89 +/- 0.23 microg L(-1) (P < 0.001) and PICP from 126.4 +/- 10.9 to 96.0 +/- 6.5 microg L(-1) (P < 0.001). In parallel, the ICTP concentration, reflecting bone resorption, decreased from 5.10 +/- 0.54 to 3.94 +/- 0.34 microg L(-1) (P < 0.001). There was not any significant change in distal radius bone mineral 1 one year after surgery. In the subgroup of patients classified as mild pHPT, a significant decrease was noted for osteocalcin, PICP and for ICTP but not for ALP, without significant changes in variables reflecting distal radius bone mineral content. Glomerular filtration rate was inversely correlated to serum levels of intact PTH, ionized calcium, alkaline phosphatase, osteocalcin and ICTP and directly correlated to the 1.25-dihydroxy-vitamin D concentrations.

CONCLUSIONS

pHPT is associated with substantial changes in circulating levels of biochemical markers of bone formation and resorption. These findings are also present in patients with mild pHPT. Renal function should be considered in the evaluation of the impact of pHPT on bone turnover.

Authors+Show Affiliations

Department of Internal Medicine, Lund University Hospital, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9566639

Citation

Valdemarsson, S, et al. "Increased Biochemical Markers of Bone Formation and Resorption in Primary Hyperparathyroidism With Special Reference to Patients With Mild Disease." Journal of Internal Medicine, vol. 243, no. 2, 1998, pp. 115-22.
Valdemarsson S, Lindergård B, Tibblin S, et al. Increased biochemical markers of bone formation and resorption in primary hyperparathyroidism with special reference to patients with mild disease. J Intern Med. 1998;243(2):115-22.
Valdemarsson, S., Lindergård, B., Tibblin, S., & Bergenfelz, A. (1998). Increased biochemical markers of bone formation and resorption in primary hyperparathyroidism with special reference to patients with mild disease. Journal of Internal Medicine, 243(2), 115-22.
Valdemarsson S, et al. Increased Biochemical Markers of Bone Formation and Resorption in Primary Hyperparathyroidism With Special Reference to Patients With Mild Disease. J Intern Med. 1998;243(2):115-22. PubMed PMID: 9566639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased biochemical markers of bone formation and resorption in primary hyperparathyroidism with special reference to patients with mild disease. AU - Valdemarsson,S, AU - Lindergård,B, AU - Tibblin,S, AU - Bergenfelz,A, PY - 1998/5/5/pubmed PY - 1998/5/5/medline PY - 1998/5/5/entrez SP - 115 EP - 22 JF - Journal of internal medicine JO - J Intern Med VL - 243 IS - 2 N2 - OBJECTIVES: To evaluate the impact on bone turnover of primary hyperparathyroidism (pHPT) with special reference to patients with mild pHPT, using biochemical markers of bone formation and resorption. DESIGN: A longitudinal study of patients with pHPT before and one year after surgical treatment. SETTING: The Departments of Internal Medicine and Surgery, Lund University Hospital. SUBJECTS: Forty consecutive patients with pHPT. Thirty of these patients had mild pHPT and are reported separately. Data on bone mineral was also compared to a reference population. INTERVENTION: All patients were operated upon and restudied one year later. MAIN OUTCOME MEASURES: Bone resorption and formation was studied by means of the serum concentrations of the telopeptide of the carboxyterminal region of type 1 collagen (ICTP) and of alkaline phosphatase (ALP), osteocalcin and the carboxyterminal propeptide of type 1 procollagen (PICP), respectively. Bone density was measured at the distal radius by single photon absorptiometry (SPA). RESULTS: Bone formation markers consistently decreased after parathyroid surgery: ALP from 3.51 +/- 0.23 to 2.94 +/- 0.21 microkat L(-1) (P < 0.05), osteocalcin from 6.15 +/- 0.53 to 2.89 +/- 0.23 microg L(-1) (P < 0.001) and PICP from 126.4 +/- 10.9 to 96.0 +/- 6.5 microg L(-1) (P < 0.001). In parallel, the ICTP concentration, reflecting bone resorption, decreased from 5.10 +/- 0.54 to 3.94 +/- 0.34 microg L(-1) (P < 0.001). There was not any significant change in distal radius bone mineral 1 one year after surgery. In the subgroup of patients classified as mild pHPT, a significant decrease was noted for osteocalcin, PICP and for ICTP but not for ALP, without significant changes in variables reflecting distal radius bone mineral content. Glomerular filtration rate was inversely correlated to serum levels of intact PTH, ionized calcium, alkaline phosphatase, osteocalcin and ICTP and directly correlated to the 1.25-dihydroxy-vitamin D concentrations. CONCLUSIONS: pHPT is associated with substantial changes in circulating levels of biochemical markers of bone formation and resorption. These findings are also present in patients with mild pHPT. Renal function should be considered in the evaluation of the impact of pHPT on bone turnover. SN - 0954-6820 UR - https://www.unboundmedicine.com/medline/citation/9566639/Increased_biochemical_markers_of_bone_formation_and_resorption_in_primary_hyperparathyroidism_with_special_reference_to_patients_with_mild_disease_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0954-6820&amp;date=1998&amp;volume=243&amp;issue=2&amp;spage=115 DB - PRIME DP - Unbound Medicine ER -