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Body Weight and Bone Mineral Density in Postmenopausal Women with Primary Hyperparathyroidism

Andrew B. Grey, MB, ChB; Margaret C. Evans, BSc; Joanne P. Stapleton, RGON; and Ian R. Reid, MD
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From the University of Auckland, Auckland, New Zealand. Requests for Reprints: Ian R. Reid, MD, Department of Medicine, University of Auckland, Private Bag 92019, Auckland 1, New Zealand. Grant Support: In part by the Auckland Medical Research Foundation, the Health Research Council of New Zealand, and the New Zealand Lottery Board.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(10):745-749. doi:10.7326/0003-4819-121-10-199411150-00003
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Objective: To assess bone mineral density and body composition in postmenopausal women with primary hyperparathyroidism.

Design: Cross-sectional study with an age-matched control group.

Setting: University teaching hospital.

Patients: 41 postmenopausal women with mild primary hyperparathyroidism and 43 eucalcemic, age-matched controls.

Measurements: Total body, lumbar spine, and proximal femoral (femoral neck, Ward's triangle, and trochanter) bone mineral density; body composition; and fat distribution were measured using dual-energy x-ray absorptiometry.

Results: Women with primary hyperparathyroidism were heavier (75.5 kg compared with 66.3 kg; difference, 9.2 kg [95% CI, 3.7 to 14.7 kg]; P = 0.002), had a higher fat mass (33.3 kg compared with 26.1 kg; difference, 7.2 kg [CI, 3.0 to 11.4 kg]; P = 0.001), and had a more android pattern of fat distribution (android-to-gynoid fat ratio, 1.05 compared with 0.84; difference, 0.21 [CI, 0.1 to 0.32]; P = 0.0004) than the controls. Unadjusted bone mineral density was similar in patients and controls at all sites: total body, 0.990 compared with 1.023 g/cm2 (difference, 0.033; CI, −0.004 to 0.070); posteroanterior lumbar spine, 1.032 compared with 1.018 g/cm2 (difference, 0.014; CI, −0.031 to 0.059); lateral lumbar spine, 0.569 compared with 0.528 g/cm2 (difference, 0.041; CI, −0.022 to 0.104); femoral neck, 0.799 compared with 0.825 g/cm2 (difference, 0.026; CI, −0.072 to 0.124); Ward's triangle, 0.653 compared with 0.677 g/cm 2 (difference, 0.024; CI, −0.035 to 0.089); trochanter, 0.734 compared with 0.733 g/cm2 (difference, 0.001; CI, −0.024 to 0.026); and arms, 0.720 compared with 0.739 g/cm2 (difference, 0.019; CI, −0.015 to 0.053). After adjustment for body weight, bone mineral density in women with primary hyperparathyroidism was lower than that in controls for total body (P = 0.0004), femoral neck (P = 0.001), Ward's triangle (P = 0.01), trochanter (P = 0.02), and arms (P = 0.0006). Spinal bone mineral density did not differ between groups.

Conclusions: Body weight, total body fat mass, and proportion of android fat are increased in postmenopausal women with primary hyperparathyroidism; these unexplained factors may be relevant to the increased incidence of cardiovascular disease in this condition. Unadjusted bone mineral density values are similar in patients with primary hyperparathyroidism and in controls, suggesting that this condition is not associated with an increased risk for fracture.


Grahic Jump Location
Figure 1.
Unadjusted bone mineral density results in postmenopausal women with primary hyperparathyroidism (n = 41) and eucalcemic controls (n = 43).

The horizontal bars indicate 95% confidence intervals. No significant differences were found between the groups at any site. PA = posteroanterior.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Bone mineral density results in postmenopausal women with primary hyperparathyroidism (n = 41) and eucalcemic controls (n = 43), adjusted for body weight.PPP

The horizontal bars indicate 95% confidence intervals. PA = posteroanterior.* < 0.05, **  < 0.01, ***  < 0.001.

Grahic Jump Location




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