The Role of Baseline Bone Mineral Density in Predicting Skeletal Recovery Following Parathyroidectomy in Patients with Primary Hyperparathyroidism

Muhammet Kocabaş; Yusuf Öztürk; Hülya Kaynak; Mahmut Esat Elbistan; Hatice Erdoğan; Melia Karaköse; Mustafa Kulaksızoğlu; Feridun Karakurt

doi:10.54005/geneltip.1752331

EN TR

The Role of Baseline Bone Mineral Density in Predicting Skeletal Recovery Following Parathyroidectomy in Patients with Primary Hyperparathyroidism

Abstract

Aim: Primary hyperparathyroidism (PHPT) adversely affects skeletal health, primarily through increased bone resorption. Parathyroidectomy (PTx) is the definitive treatment, but the extent of skeletal recovery and its predictive factors are not fully understood. This study aimed to assess the impact of PTx on bone mineral density (BMD) and to identify predictors of postoperative skeletal improvement. Methods: This retrospective cohort study included 65 patients with PHPT who underwent successful PTx at a single tertiary center between January 2018 and January 2024. We collected demographic, clinical, and biochemical data. BMD and T-scores were measured at the lumbar spine, femoral neck, total hip, and distal one-third radius using dual-energy X-ray absorptiometry (DXA) at baseline and 12 months postoperatively. Percentage changes in BMD were calculated. Correlations between BMD changes and preoperative demographic, biochemical, and DXA parameters were analyzed. Results: Significant improvements in BMD and T-score were observed at all sites one year after PTx, with the greatest increases in the lumbar spine and femoral neck (mean BMD increases of 10.33% and 10.43%, respectively; p < 0.001). Lower baseline BMD and T-score, especially at the one-third radius, were associated with greater postoperative gains. Adenoma size and PTH levels showed weak positive correlations with BMD changes, while 25-hydroxyvitamin D and phosphorus levels were inversely correlated in certain regions. Conclusions: PTx results in significant skeletal recovery in PHPT, with the most pronounced gains observed at trabecular-rich sites. Preoperative skeletal status, specifically at the one-third radius, serves as a valuable predictor of overall postoperative recovery. These findings support the importance of PTx in patients with PHPT and low bone mass and highlight the value of baseline skeletal status in predicting postoperative outcomes

Keywords

Primary hyperparathyroidism , parathyroidectomy , bone mineral density , T-score , predictive factors

Primer Hiperparatiroidizmli Hastalarda Paratiroidektomi Sonrası İskelet İyileşmesinin Tahmininde Bazal Kemik Mineral Yoğunluğunun Rolü

Öz

Amaç: Primer hiperparatiroidizm (PHPT), öncelikle kemik rezorpsiyonunu artırarak iskelet sağlığını olumsuz etkiler. Kesin tedavi paratiroidektomi (PTx) olmakla birlikte iskelet iyileşmesinin boyutu ve bunu öngördüren faktörler tam olarak bilinmemektedir. Bu çalışmada, PTx’in kemik mineral yoğunluğu (KMY) üzerindeki etkisi ve postoperatif iskelet iyileşmesini öngördüren faktörlerin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif kohort çalışmasına, Ocak 2018 ile Ocak 2024 tarihleri arasında üçüncü basamak bir merkezde başarılı PTx uygulanmış olan 65 PHPT hastası dahil edildi. Demografik, klinik ve biyokimyasal veriler toplandı. KMY ve T-skoru değerleri, dual-enerji X-ışını absorbsiyometrisi (DXA) ile lomber vertebra, femur boynu, total kalça ve distal 1/3 radius bölgelerinde başlangıçta ve postoperatif 12. ayda ölçüldü. KMY’deki yüzde değişimler hesaplandı. KMY değişimleri ile preoperatif demografik, biyokimyasal ve DXA parametreleri arasındaki korelasyonlar analiz edildi. Bulgular: PTx’den bir yıl sonra tüm bölgelerde anlamlı KMY ve T-skoru artışları gözlendi; en belirgin artışlar lomber vertebra ve femur boynunda saptandı (sırasıyla ortalama KMY artışı %10,33 ve %10,43; p<0.001). Özellikle distal 1/3 radius bölgesinde düşük başlangıç KMY ve T-skoruna sahip hastalarda postoperatif kazanımlar daha yüksek bulundu. Adenom boyutu ve PTH düzeyleri KMY değişimleriyle zayıf pozitif korelasyon gösterirken, 25-hidroksivitamin D ve fosfor düzeyleri bazı bölgelerde KMY değişimleriyle ters orantılıydı. Sonuçlar: PTx, PHPT'de önemli iskelet iyileşmesine yol açar ve en belirgin kazanımlar trabeküler kemikten zengin bölgelerde gözlenir. Cerrahi öncesi iskelet durumu (özellikle de distal 1/3 radius bölgesinde) postoperatif genel iskelet iyileşmesinin değerli bir öngördürücüsüdür. Bu bulgular, PHPT'li ve düşük kemik kütlesine sahip hastalarda PTx'in önemini desteklemekte ve postoperatif sonuçları tahmin etmede başlangıç iskelet durumunun değerini vurgulamaktadır.

Anahtar Kelimeler

Primer hiperparatiroidizm , paratiroidektomi , kemik mineral yoğunluğu , T-skoru , prediktif faktörler

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Details

Primary Language

English

Subjects

Endocrinology

Journal Section

Research Article

Authors

Muhammet Kocabaş ^*
0000-0002-6473-4164
Türkiye

Yusuf Öztürk
0000-0001-7526-6063
Türkiye

Hülya Kaynak
0000-0001-6008-4742
Türkiye

Mahmut Esat Elbistan
0000-0002-5760-1953
Türkiye

Hatice Erdoğan
0000-0002-1231-3640
Türkiye

Melia Karaköse
0000-0001-7990-8350
Türkiye

Mustafa Kulaksızoğlu
0000-0001-9908-7449
Türkiye

Feridun Karakurt
0000-0001-7629-9625
Türkiye

Publication Date

January 29, 2026

Submission Date

July 28, 2025

Acceptance Date

September 15, 2025

Published in Issue

Year 2026 Volume: 36 Number: 2026

DOI

https://doi.org/10.54005/geneltip.1752331

IZ

https://izlik.org/JA39YX52RK

Vancouver

1.Muhammet Kocabaş, Yusuf Öztürk, Hülya Kaynak, Mahmut Esat Elbistan, Hatice Erdoğan, Melia Karaköse, Mustafa Kulaksızoğlu, Feridun Karakurt. The Role of Baseline Bone Mineral Density in Predicting Skeletal Recovery Following Parathyroidectomy in Patients with Primary Hyperparathyroidism. Genel Tıp Derg. 2026 Jan. 1;36(2026):1-7. doi:10.54005/geneltip.1752331

The Journal of General Medicine is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).

The Role of Baseline Bone Mineral Density in Predicting Skeletal Recovery Following Parathyroidectomy in Patients with Primary Hyperparathyroidism

Abstract

Keywords

Primer Hiperparatiroidizmli Hastalarda Paratiroidektomi Sonrası İskelet İyileşmesinin Tahmininde Bazal Kemik Mineral Yoğunluğunun Rolü

Öz

Anahtar Kelimeler

References

Details

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Subjects

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Publication Date

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Acceptance Date

Published in Issue

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