Copyright
©
AE&M all rights reserved.
394
original article
Arch Endocrinol Metab. 2019;63/4
Prediction of bone mass changes
after successful parathyroidectomy
using biochemical markers
of bone metabolism in
primary hyperparathyroidism:
is it clinically useful?
Monique Nakayama Ohe
1
https://orcid.org/0000-0003-4900-7185
Teresa Cristina Piscitelli Bonanséa
1
Rodrigo Oliveira Santos
2
Murilo Catafesta das Neves
2
https://orcid.org/0000-0002-8094-6298
Livia Marcela Santos
1
Marcello Rosano
2
https://orcid.org/0000-0002-3026-466X
Ilda Sizue Kunii
1
Marise Lazaretti Castro
1
https://orcid.org/0000-0001-9186-2834
José Gilberto Henriques Vieira
1
ABSTRACT
Objective: To measure type 1 serum amino-terminal propeptide procollagen (P1NP) and type 1
cross-linked C-terminal telopeptide collagen (CTX) before parathyroidectomy (PTX) in PHPT patients,
correlating these measurements with bone mineral density (BMD) changes. Subjects and methods:
31 primary hyperparathyroidism (HPTP) were followed from diagnosis up to 12-18 months after
surgery. Serum levels of calcium, parathyroid hormone (PTH) vitamin D, CTX, P1NP, and BMD were
measured before and 1 year after surgery. Results: One year after PTX, the mean BMD increased by
8.6%, 5.5%, 5.5%, and 2.2% in the lumbar spine, femoral neck (FN), total hip (TH), and distal third of the
nondominant radius (R33%), respectively. There was a significant correlation between BMD change
1 year after the PTX and CTX (L1-L4: r = 0.614, p < 0.0003; FN: r = 0.497, p < 0.0051; TH: r = 0.595, p
< 0.0005; R33%: r = 0.364, p < 0.043) and P1NP (L1-L4: r = 0,687, p < 0,0001; FN: r = 0,533, p < 0,0024;
TH: r = 0,642, p < 0,0001; R33%: r = 0,467, p < 0,0079) preoperative levels. The increase in 25(OH)D
levels has no correlation with BMD increase (r = -0.135; p = 0.4816). On linear regression, a minimum
preoperative CTX value of 0.331 ng/mL or P1NP of 37.9 ng/mL was associated with a minimum 4%
increase in L1-L4 BMD. In TH, minimum preoperative values of 0.684 ng/mL for CTX and 76.0 ng/
mL for P1NP were associated with a ≥ 4% increase in BMD. Conclusion: PHPT patients presented
a significant correlation between preoperative levels of turnover markers and BMD improvement 1
year after PTX. Arch Endocrinol Metab. 2019;63(4):394-401
Keywords
Biochemical markers of bone turnover; parathyroid-related disorders; DXA; PTH; osteoporosis
Correspondence to:
Teresa Cristina Piscitelli Bonanséa
Rua Borges Lagoa, 800
04032001 – São Paulo, SP, Brasil
tebonanse@hotmail.com
Received on Jan/15/2017
Accepted on Nov/8/2017
DOI: 10.20945/2359-3997000000154
1
Departamento de Endocrinologia
e Metabolismo, Escola Paulista
de Medicina, Universidade
Federal de São Paulo
(EPM-Unifesp), São Paulo, SP, Brasil
2
Departamento de
Otorrinolaringologia, Cabeça
e Pescoço, EPM-Unifesp,
São Paulo, SP, Brasil