Your browser doesn't support javascript.
loading
Skeletal Effect of Parathyroidectomy on Patients With Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis.
Kongsaree, Nattanan; Thanyajaroen, Thanaporn; Dechates, Bothamai; Therawit, Phonthip; Mahikul, Wiriya; Ngaosuwan, Kanchana.
Afiliación
  • Kongsaree N; Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand.
  • Thanyajaroen T; Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand.
  • Dechates B; Endocrinology and Metabolism Unit, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand.
  • Therawit P; Endocrinology and Metabolism Unit, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok 10210, Thailand.
  • Mahikul W; Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand.
  • Ngaosuwan K; Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand.
J Clin Endocrinol Metab ; 109(10): e1922-e1935, 2024 Sep 16.
Article en En | MEDLINE | ID: mdl-38739762
ABSTRACT
CONTEXT Parathyroidectomy (PTX) is recommended for curing primary hyperparathyroidism (PHPT), although uncertainty remains regarding the extent of fracture risk reduction following surgery.

OBJECTIVE:

This work aimed to compare fracture risk and bone mineral density (BMD) changes in patients with PHPT undergoing PTX vs observation (OBS).

METHODS:

We systematically searched PubMed, Embase, and the Cochrane Library until September 2022, including randomized controlled trials (RCTs) and cohort studies, and reviewed citations from previous reviews. Among 1260 initial records, 48 eligible articles from 35 studies (5 RCTs; 30 cohorts) included PHPT patients receiving PTX or OBS interventions with reported fracture events at any site, including the hip, spine, or forearm, and/or BMD changes at each location. Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines by 2 independent reviewers.

RESULTS:

In 238 188 PHPT patients (PTX 73 778 vs OBS 164 410), PTX significantly reduced fractures at any site (relative risk [RR], 0.80; 95% CI, 0.74-0.86) compared to OBS. In 237 217 patients (PTX 73 458 vs OBS 163 759), the risk of hip fractures decreased (RR, 0.63; 95% CI, 0.52-0.76). No reduction in forearm and vertebral fractures was observed in 3574 and 3795 patients, respectively. The annual percentage BMD changes from baseline were higher in the PTX group femoral neck, 1.91% (95% CI, 1.14-2.68); hip, 1.75% (95% CI, 0.58-2.92); radius, 1.75% (95% CI, 0.31-3.18); spine, 2.13% (95% CI, 1.16-3.10).

CONCLUSION:

PTX significantly reduced overall and hip fracture risks in PHPT patients. Despite minimal BMD increase, the substantial decrease in fracture risk suggests additional benefits of PTX beyond mineral content enhancement.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Densidad Ósea / Paratiroidectomía / Hiperparatiroidismo Primario / Fracturas Óseas Límite: Humans Idioma: En Revista: J Clin Endocrinol Metab Año: 2024 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Densidad Ósea / Paratiroidectomía / Hiperparatiroidismo Primario / Fracturas Óseas Límite: Humans Idioma: En Revista: J Clin Endocrinol Metab Año: 2024 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Estados Unidos