Endocrine Abstracts

Introduction: The main pathogenic mechanism of bone development disease in primary hyperparathyroidism (PHPT) is speeding bone resorbtion over bone formation rate.

Objective: Studying the features of bone disease in different clinical variants of PHPT.

Materials and methods: We have studied 114 patients with PGPT (average age 52.19) a general medical examination has been made. The questionnaire perfomed (with the estimate of anamnestic data, osteoporosis risk factors), the study of indicators of calcium-phosphorus metabolism (PTH, Ca, Ca²⁺, P), bone markers (alkaline phosphatase, osteocalcin, β-CTX), sonography of the thyroid and PTG, scintigraphy PTG, bone mineral density was also examined.

Results: 8 men and 106 women have been examined, 100% of men were within the age group of 50 years. 24.5% of women are of childbearing age and 75.5% of them were in the physiological or surgically induced menopause. 38.7% of patients had mild forms of PHPT, 61.3% – symptomatic PHPT (21% – visceral, bone – 17.5%, mixed form 22.8%). Low bone density was detected in 75.9% of the cases (34.5% osteoporosis, 41.4% osteopenia). In 3.5% there was detected classical Recklinghausen’s osteodystrophy with multiple injuries of the skeleton. 9% of the patients were marked with pathological fractures. In 13.6% of cases of mild forms of PHPT osteoporosis was detected, osteopenia – 6.8%. Bone forms of PHPT: Recklinghausen’s osteodystrophy was detected in 10%, osteoporosis - 65%, osteopenia – in 25% of cases. Mixed forms of PHPT: Recklinghausen’s osteodystrophy was detected in 7.7%, osteoporosis – 61.5%, osteopenia – 19% cases. The visceral forms: osteoporosis – 25%, osteopenia – 9.5%.

Conclusion: These results suggest a high prevalence of bone disease in patients with manifested forms of primary hyperparathyroidism, and the low frequency of mild forms of PHPT.