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Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis

BACKGROUND: Parathyroidectomy (PTx) reportedly increases bone mineral density (BMD) in patients with severe secondary hyperparathyroidism (SHPT). To date, however, there has not been sufficient evidence on predictors of BMD improvement post-PTx for SHPT, an issue the present retrospective cohort stu...

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Autores principales: Okada, Manabu, Tominaga, Yoshihiro, Tomosugi, Toshihide, Hiramitsu, Takahisa, Ichimori, Toshihiro, Sato, Tetsuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322001/
https://www.ncbi.nlm.nih.gov/pubmed/34132848
http://dx.doi.org/10.1007/s00268-021-06186-1
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author Okada, Manabu
Tominaga, Yoshihiro
Tomosugi, Toshihide
Hiramitsu, Takahisa
Ichimori, Toshihiro
Sato, Tetsuhiko
author_facet Okada, Manabu
Tominaga, Yoshihiro
Tomosugi, Toshihide
Hiramitsu, Takahisa
Ichimori, Toshihiro
Sato, Tetsuhiko
author_sort Okada, Manabu
collection PubMed
description BACKGROUND: Parathyroidectomy (PTx) reportedly increases bone mineral density (BMD) in patients with severe secondary hyperparathyroidism (SHPT). To date, however, there has not been sufficient evidence on predictors of BMD improvement post-PTx for SHPT, an issue the present retrospective cohort study aimed to address. METHODS: A total of 173 SHPT patients who underwent total PTx with forearm autograft between 2009 and 2017 were included in the present study. Demographic information, perioperative laboratory data and pre- and post-PTx BMD values (measured by dual-energy X-ray absorptiometry) were collected from their medical records. The change in BMD post-PTx in the lumbar spine was evaluated as the primary outcome. Then, a multivariate logistic regression analysis was performed for a ≥ 10% increase in BMD post-PTx. RESULTS: Overall, the median BMD in the lumbar spine was increased by 8.7% post-PTx. The multivariate logistic regression analysis revealed that age ≥ 70 years (P = 0.005; odds ratio [OR], 0.138; 95% confidence interval [CI]: 0.034–0.555), serum Ca level (P = 0.017; OR, 0.598; 95% CI: 0.392–0.911) and pre-PTx BMD in the lumbar spine (P = 0.003; OR, 0.013; 95% CI: 0.001–0.229) were negatively associated with a ≥ 10% increase in BMD post-PTx. CONCLUSION: Our study demonstrated that presurgical age, serum Ca levels and BMD values could better predict an improvement in BMD post-PTx in SHPT patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00268-021-06186-1.
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spelling pubmed-83220012021-08-19 Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis Okada, Manabu Tominaga, Yoshihiro Tomosugi, Toshihide Hiramitsu, Takahisa Ichimori, Toshihiro Sato, Tetsuhiko World J Surg Original Scientific Report BACKGROUND: Parathyroidectomy (PTx) reportedly increases bone mineral density (BMD) in patients with severe secondary hyperparathyroidism (SHPT). To date, however, there has not been sufficient evidence on predictors of BMD improvement post-PTx for SHPT, an issue the present retrospective cohort study aimed to address. METHODS: A total of 173 SHPT patients who underwent total PTx with forearm autograft between 2009 and 2017 were included in the present study. Demographic information, perioperative laboratory data and pre- and post-PTx BMD values (measured by dual-energy X-ray absorptiometry) were collected from their medical records. The change in BMD post-PTx in the lumbar spine was evaluated as the primary outcome. Then, a multivariate logistic regression analysis was performed for a ≥ 10% increase in BMD post-PTx. RESULTS: Overall, the median BMD in the lumbar spine was increased by 8.7% post-PTx. The multivariate logistic regression analysis revealed that age ≥ 70 years (P = 0.005; odds ratio [OR], 0.138; 95% confidence interval [CI]: 0.034–0.555), serum Ca level (P = 0.017; OR, 0.598; 95% CI: 0.392–0.911) and pre-PTx BMD in the lumbar spine (P = 0.003; OR, 0.013; 95% CI: 0.001–0.229) were negatively associated with a ≥ 10% increase in BMD post-PTx. CONCLUSION: Our study demonstrated that presurgical age, serum Ca levels and BMD values could better predict an improvement in BMD post-PTx in SHPT patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00268-021-06186-1. Springer International Publishing 2021-06-16 2021 /pmc/articles/PMC8322001/ /pubmed/34132848 http://dx.doi.org/10.1007/s00268-021-06186-1 Text en © The Author(s) 2021, corrected publication 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Scientific Report
Okada, Manabu
Tominaga, Yoshihiro
Tomosugi, Toshihide
Hiramitsu, Takahisa
Ichimori, Toshihiro
Sato, Tetsuhiko
Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis
title Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis
title_full Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis
title_fullStr Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis
title_full_unstemmed Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis
title_short Predictors of Bone Mineral Density Improvement after Parathyroidectomy for Secondary Hyperparathyroidism: A Retrospective Single-Center Analysis
title_sort predictors of bone mineral density improvement after parathyroidectomy for secondary hyperparathyroidism: a retrospective single-center analysis
topic Original Scientific Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322001/
https://www.ncbi.nlm.nih.gov/pubmed/34132848
http://dx.doi.org/10.1007/s00268-021-06186-1
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