Endocrine Abstracts

JOINT1436

PHPT is nowadays the third more common endocrine disease, with an estimated prevalence in the general population of 0.5%-1% that increase more than 2% with age in both sexes. PTX is the only definitive treatment for PHPT with very high cure rate and it is recommended for all PHPT patients with symptomatic disease and for asymptomatic patients meeting surgical criteria, updated over time in an inclusive way toward. To date osteoporosis is the surgical criteria more ofteen met while osteopenia is not taken into account as surgical indication. PTX improves bone mineral density and reduce bone remodeling biomarkers also in patients with milder PHPT forms, on the other hand whether PTX is linked to fracture risk reduction also in milder forms of PHPT is still debated. Recently, it has been reported that PTX was associated with a lower risk of fracture in older adults independently by frailty categories, presence of osteoporosis, and criteria for operative management suggested by guidelines. Our study aimed to evaluate the prevalence and clinical features of osteopenic males PHPT patients. From a consecutive series of 435 subjects with PHPT and densitometric data available on 3 sites (lumbar, femoral and radial) we selected 90 male subjects. In this subgroup, we focused on the 31 with osteopenia (34.4% of males). They were classified as symptomatic in 61.3% and asymptomatic in 38.7% of cases. Among the symptomatic, 94.7% have renal involvement. Among asymptomatics, the most frequently met criteria are age (100%) and 24-hour Urinary Calcium (80%). In conclusion, male PHPT subjects with osteopenia are almost 1/5 of PHPT patients with osteopenia and are symptomatic in the majority of cases, mostly due to renal involvement. Among asymptomatic subjects, 54.5% did not meet any criteria for surgery.