Biological secondary contributors to osteoporosis in fractured patients, is an early systematic assay relevant?
Publication date: Available online 9 April 2019Source: Joint Bone SpineAuthor(s): Pierre-Emmanuel Cailleaux, David Biau, Leclerc Philippe, Anract Philippe, Roux Christian, Briot KarineAbstractObjective:To evaluate the prevalence of biological abnormalities leading to secondary osteoporosis in recently fractured patients.Methods:Adults older than 50, hospitalized for a nonvertebral fracture from July 2015 to October 2016, were assessed for bone fragility contributors in the Orthopedics Department. Bone mineral density (BMD) measurements and Vertebral Fracture assessment (VFA) were performed within 3 months. We assessed the prevalence of biological abnormalities in all the patients with recent fracture and in subgroups.Results:Among 439 hospitalized patients for non-vertebral low trauma fracture, 372 had biological tests (285 women, mean age 77.5 ± 13 years) and 353 (94.6%) had at least ≥ 1 biological abnormality, most frequently vitamin D insufficiency (
, Muñoz-Torres M Abstract CONTEXT: primary hyperparathyroidism (PHPT) has been related to bone loss. Dual-energy X-ray absorptiometry (DXA) cannot distinguish between trabecular and cortical bone compartments but the recently developed 3D-DXA software might overcome this issue. OBJECTIVE: to examine the differences in DXA-derived areal bone mineral density (aBMD) and 3D-DXA parameters at the hip site between patients with PHPT and a healthy control group. DESIGN: cross-sectional pilot study. SETTING: hospital. PATIENTS: 80 adults (59.5 ± 9.1 yrs), 40 with PHPT and 40 healthy age- ...
AbstractPurposeScreening for vertebral fractures (VF) in primary hyperparathyroidism (PHPT) is recommended, but there are limited data regarding which patients are at greatest risk for VF. We evaluated risk factors for VF in PHPT.MethodsThis is a retrospective cross-sectional analysis of 117 participants with PHPT. We assessed Grades 2 and 3 VF by vertebral fracture assessment (VFA) and the association of VF with the trabecular bone score (TBS), other skeletal parameters and clinical risk factors. VFA was performed only in those who met National Osteoporosis Foundation criteria for VFA screening.ResultsT-scores were in the...
This article is protected by copyright. All rights reserved. PMID: 31538675 [PubMed - as supplied by publisher]
This article is protected by copyright. All rights reserved.
Conditions: Primary Hyperparathyroidism; Osteoporosis Interventions: Drug: Denosumab 60 MG/ML Prefilled Syringe [Prolia]; Drug: Zoledronic Acid Sponsor: University Medical Centre Ljubljana Recruiting
AbstractSecondary hyperparathyroidism is a frequent complication of chronic kidney disease that begins early in the course of renal insufficiency as an adaptive response to maintain mineral homeostasis. This complex disorder affects the bone, leading to an increase in fracture risk and is associated with increased risks of vascular calcification and mortality.Purpose of ReviewIn this review, we examine the different strategies available to manage secondary hyperparathyroidism. Particularly, we focus on the adequate control of serum phosphorus by restricting intake and the use of phosphate binders, correction of hypocalcemi...
ConclusionFor primary hyperparathyroidism with severe bone disease, focused unilateral parathyroidectomy is likely to reduce the duration of postoperative hospital stay. Preoperative total serum calcium is not a reliable predictor of hospital stay in this subset of patients.