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  • Lundstam, KarolinaGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Radiol, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Radiol, Gothenburg, Sweden. (författare)

Positive Effect of Parathyroidectomy Compared to Observation on BMD in a Randomized Controlled Trial of Mild Primary Hyperparathyroidism

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • 2023-01-20
  • Wiley,2023

Nummerbeteckningar

  • LIBRIS-ID:oai:gup.ub.gu.se/324411
  • https://gup.ub.gu.se/publication/324411URI
  • https://doi.org/10.1002/jbmr.4763DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-502167URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:151907362URI

Kompletterande språkuppgifter

  • Språk:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Mild or asymptomatic disease is now the dominating presentation of primary hyperparathyroidism (PHPT). However, bone involvement with decreased bone mineral density (BMD) and an increased risk of fractures has been demonstrated. Indications for parathyroidectomy (PTX) in mild PHPT have been debated for years. There is a need of long-term randomized studies comparing PTX with observation without intervention (OBS). Here, we present bone health data from the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH), a randomized controlled trial, comparing PTX to OBS. This study included 191 patients (96 OBS/95 PTX), and 129 patients (64 OBS/65 PTX) were followed for 10 years to the end of study (EOS). BMD was measured with dual-energy X-ray absorptiometry (DXA), peripheral fractures were noted, and spine radiographs were obtained for vertebral fracture assessment. There was a significant treatment effect of PTX on BMD compared with OBS for all analyzed compartments, most explicit for the lumbar spine (LS) and femoral neck (FN) (p < 0.001). The mean changes in T-score from baseline to 10 years were from 0.41 for radius 33% (Rad33) to 0.58 for LS greater in the PTX group than in the OBS group. There was a significant decrease in BMD for all compartments in the OBS group, most pronounced for FN, Rad33, and ultradistal radius (UDR) (p < 0.001). Even though there was a significant treatment effect of PTX compared with OBS, there was only a significant increase in BMD over time for LS (p < 0.001). We found no difference between groups in fracture frequency in the 10-year cohort, neither with modified intention-to-treat (mITT) analysis nor per protocol analysis. Because BMD is only a surrogate endpoint of bone health and PTX did not reduce fracture risk, observation could be considered a safe option for many patients with mild PHPT regarding bone health in a 10-year perspective.(c) 2023 The Authors.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Pretorius, M.Oslo Univ Hosp, Sect Specialized Endocrinol, Oslo, Norway.;Univ Oslo, Fac Med, Oslo, Norway. (författare)
  • Bollerslev, J.Oslo Univ Hosp, Sect Specialized Endocrinol, Oslo, Norway.;Univ Oslo, Fac Med, Oslo, Norway. (författare)
  • Godang, K.Oslo Univ Hosp, Sect Specialized Endocrinol, Oslo, Norway. (författare)
  • Fagerland, M. W.Oslo Univ Hosp, Oslo Ctr Biostat & Epidemiol, Res Support Serv, Oslo, Norway. (författare)
  • Mollerup, C.Rigshosp, Copenhagen Univ Hosp, Ctr HOC, Clin Breast & Endocrine Surg, Copenhagen, Denmark. (författare)
  • Fougner, S. L.Trondheim Reg & Univ Hosp, St Olavs Hosp, Dept Endocrinol, Clin Med, Trondheim, Norway. (författare)
  • Pernow, Y.Karolinska Institutet (författare)
  • Aas, T.Haukeland Hosp, Dept Breast & Endocrine Surg, Bergen, Norway. (författare)
  • Hessman, OlaUppsala universitet,Institutionen för kirurgiska vetenskaper,Centrum för klinisk forskning, Västerås(Swepub:uu)olahessm (författare)
  • Rosen, T.Sahlgrens Univ Hosp, Sect Endocrinol Diabet & Metab, Dept Med, Gothenburg, Sweden. (författare)
  • Nordenstrom, J.Karolinska Institutet (författare)
  • Jansson, Svante,1948Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Univ Gothenburg, Sahlgrenska Univ Hosp, Sahlgrenska Acad, Inst Clin Sci,Dept Surg, Gothenburg, Sweden.(Swepub:gu)xjanss (författare)
  • Hellström, Mikael,1950Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology,Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Radiol, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Radiol, Gothenburg, Sweden.(Swepub:gu)xhelmi (författare)
  • Heck, A.Oslo Univ Hosp, Sect Specialized Endocrinol, Oslo, Norway.;Univ Oslo, Fac Med, Oslo, Norway. (författare)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för radiologi (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Journal of Bone and Mineral Research: Wiley38:3, s. 372-3800884-04311523-4681

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