Abstract
CONTEXT: Primary hyperparathyroidism reduces bone mineral density, which increases the risk of fracture. OBJECTIVE: To investigate differences in bone mineral density and clinical characteristics after parathyroidectomy between men and women (premenopausal and postmenopausal) with sporadic primary hyperparathyroidism. DESIGN: This is a retrospective study of adult patients who underwent parathyroidectomy in a tertiary referral center from 1990 to 2013. PATIENTS: A total of 1529 patients underwent parathyroidectomy during the study period; 80 patients met the inclusion criteria. Of these, 24 were men and 56 were women (10 premenopausal and 46 postmenopausal). MEASUREMENTS: Demographics, preoperative and postoperative biochemical analysis, preoperative and postoperative T-scores, preoperative Z-scores, preoperative and postoperative absolute bone mineral density values, and percentage change in bone mineral density from baseline to 12 ± 6 months after parathyroidectomy in the lumbar spine, femoral neck, total hip and distal one-third of the nondominant radius. RESULTS: Preoperative 24-hour urinary calcium levels were significantly higher in men than in women overall (P = 0.02) and postmenopausal women (P = 0.01). Men had significantly lower preoperative Z-scores than women overall, premenopausal women and postmenopausal women. Men had greater percentage change of increase in bone mineral density in the femoral neck than did women overall (2.77%; P = 0.04) and postmenopausal women (2.98%; P = 0.03) 1 year after parathyroidectomy. CONCLUSIONS: From this study, men demonstrated a greater improvement of bone mineral density in the femoral neck from baseline after parathyroidectomy compared with women.