Long-term irreversibility of bone loss after surgery for primary hyperparathyroidism
Article Abstract:
The parathyroid gland is located close to the thyroid gland in the neck region, and secretes parathyroid hormone, which regulates calcium and phosphorus metabolism in the body. The mineral content of the radial or forearm bone was shown to be reduced in patients with primary hyperparathyroidism (an increased activity of the parathyroid gland). In addition, the radial bone mineral content was shown to remain below normal one year after removal of parathyroid tumors in 30 patients. Measurements of radial bone mineral content in 71 patients obtained up to 107 months after surgery were reviewed. The mineral content of the radial bone was shown to be increased one year after surgery. One to eight months after the removal of the adenoma, the monthly increase in bone mineral content was 0.009 grams per liter for the radial epiphysis (end of the radial bone) and 0.0084 grams per centimeter for the shaft or middle portion of the bone. However, among 39 patients assessed one year after surgery, the bone mineral content remained below normal values in the radial epiphysis in 36 to 61 percent of patients and in the radial shaft in 26 to 59 percent of patients. After the first year following surgery, the monthly rate of increase in bone mineral content decreased rapidly with time, resulting in only slight increases in bone mineral content. These findings indicate that loss of bone associated with hyperparathyroidism, and the increased fracture risk associated with this bone loss, is maintained throughout life. Supplementation with calcium and/or vitamin D may help improve recovery of bone mineral content after surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Determinants of vertebral mineral density in patients receiving long-term glucocorticoid therapy
Article Abstract:
Osteoporosis, a condition of reduced bone density, can sometimes accompany steroid therapy, but the relationship of bone loss to steroid dose is not well understood. Steroids are known to decrease bone formation and absorption of calcium by the intestines, and to increase calcium loss in urine and to enhance the normal process of bone resorption (removal). It is also unclear whether bone loss progresses beyond initial stages of treatment, and the influence of factors such as age and sex is not documented. The relationship between mineral levels in vertebral (spinal) bone and steroid therapy was evaluated in 35 patients (16 female), aged 17 to 77 years, who were treated with steroids for up to 22 years for asthma or connective tissue diseases such as systemic lupus erythematosus. Vertebral mineral density (VMD) was lower than normal in these patients, and decreased with respect to duration and total dosage of steroid therapy. Age and gender did not appear to influence steroid-related decreases in VMD. Losses in VMD could not be correlated to laboratory tests of calcium metabolism such as urinary calcium excretion. The study indicates that the dosage and duration of steroid should be kept as low as possible so as to minimize adverse effects on bone mineral density. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Reappraisal of thyroxine treatment in primary hypothyroidism. Autoimmune chronic active hepatitis in a family
- Abstracts: Falls in older persons: causes and interventions. Perceived quality of life and preferences for life-sustaining treatment in older adults
- Abstracts: The association of borderline hypertension with target organ changes and higher coronary risk: Tecumseh blood pressure study