Appreciation of osteoporosis among men with hyperparathyroidism

Naveen Ballem, Andrew B. Greene, Rikesh T. Parikh, Eren Berber, Allan Siperstein, Kresimira Milas

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To define the scope of bone disease among men referred for parathyroidectomy and to document bone density screening trends in this high-risk population. Methods: Clinical data were analyzed from a prospectively maintained database of 1000 patients undergoing parathyroidectomy for sporadic primary hyperparathyroidism at the Cleveland Clinic between 2000 and 2006. Information collected included demographics, reason for referral, body mass index, intraoperative findings, preoperative and postoperative laboratory values (serum calcium, phosphorus, parathyroid hormone, 25-hydroxyvitamin D, and 24-hour urinary calcium excretion), and preoperative and postoperative dual-energy x-ray absorptiometry (DXA) findings. Results: Of the 1000 patients, 243 (24%) were men. As with women, bone health-related issues were the most common reason for referral (32%). In 2000, only 12% of men had preoperative DXA scans; this rose to 42% by 2005. The frequency of prereferral DXA screening increased throughout the study, but even by 2006, referring physicians did not screen most of their male patients. In 2000, the prevalence of bone disease (osteoporosis or osteopenia) in men was 8%, but with improved screening, this increased to 26%, approaching the 34% rate in women. Preoperative and postoperative levels of calcium, parathyroid hormone, phosphorus, 24-hour urinary calcium, and 25-hydroxyvitamin D were the same among men with and without bone disease. Analysis of postoperative DXA scans revealed that gains in postparathyroidectomy bone density were significantly greater in men than in women at all anatomic testing sites. In men, lowest T scores improved by a mean ± SEM of +0.35 ± 0.09 compared with +0.098 ± 0.035 in women (P = .009). Men were 4 times less likely than women to have continued bone loss after parathyroidectomy. Conclusions: Clinical and laboratory parameters cannot identify men with hyperparathyroidism who have bone loss, illustrating the need for routine DXA screening. Despite this, DXA remains underused. Improved screening practices will favorably effect men's health.

Original languageEnglish (US)
Pages (from-to)820-831
Number of pages12
JournalEndocrine Practice
Volume14
Issue number7
StatePublished - Oct 2008
Externally publishedYes

Fingerprint

Hyperparathyroidism
Osteoporosis
X-Rays
Parathyroidectomy
Bone Diseases
Calcium
Parathyroid Hormone
Bone and Bones
Bone Density
Phosphorus
Referral and Consultation
Men's Health
Primary Hyperparathyroidism
Metabolic Bone Diseases
Women's Health
Body Mass Index
Demography
Databases
Physicians

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Ballem, N., Greene, A. B., Parikh, R. T., Berber, E., Siperstein, A., & Milas, K. (2008). Appreciation of osteoporosis among men with hyperparathyroidism. Endocrine Practice, 14(7), 820-831.

Appreciation of osteoporosis among men with hyperparathyroidism. / Ballem, Naveen; Greene, Andrew B.; Parikh, Rikesh T.; Berber, Eren; Siperstein, Allan; Milas, Kresimira.

In: Endocrine Practice, Vol. 14, No. 7, 10.2008, p. 820-831.

Research output: Contribution to journalArticle

Ballem, N, Greene, AB, Parikh, RT, Berber, E, Siperstein, A & Milas, K 2008, 'Appreciation of osteoporosis among men with hyperparathyroidism', Endocrine Practice, vol. 14, no. 7, pp. 820-831.
Ballem N, Greene AB, Parikh RT, Berber E, Siperstein A, Milas K. Appreciation of osteoporosis among men with hyperparathyroidism. Endocrine Practice. 2008 Oct;14(7):820-831.
Ballem, Naveen ; Greene, Andrew B. ; Parikh, Rikesh T. ; Berber, Eren ; Siperstein, Allan ; Milas, Kresimira. / Appreciation of osteoporosis among men with hyperparathyroidism. In: Endocrine Practice. 2008 ; Vol. 14, No. 7. pp. 820-831.
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abstract = "Objective: To define the scope of bone disease among men referred for parathyroidectomy and to document bone density screening trends in this high-risk population. Methods: Clinical data were analyzed from a prospectively maintained database of 1000 patients undergoing parathyroidectomy for sporadic primary hyperparathyroidism at the Cleveland Clinic between 2000 and 2006. Information collected included demographics, reason for referral, body mass index, intraoperative findings, preoperative and postoperative laboratory values (serum calcium, phosphorus, parathyroid hormone, 25-hydroxyvitamin D, and 24-hour urinary calcium excretion), and preoperative and postoperative dual-energy x-ray absorptiometry (DXA) findings. Results: Of the 1000 patients, 243 (24{\%}) were men. As with women, bone health-related issues were the most common reason for referral (32{\%}). In 2000, only 12{\%} of men had preoperative DXA scans; this rose to 42{\%} by 2005. The frequency of prereferral DXA screening increased throughout the study, but even by 2006, referring physicians did not screen most of their male patients. In 2000, the prevalence of bone disease (osteoporosis or osteopenia) in men was 8{\%}, but with improved screening, this increased to 26{\%}, approaching the 34{\%} rate in women. Preoperative and postoperative levels of calcium, parathyroid hormone, phosphorus, 24-hour urinary calcium, and 25-hydroxyvitamin D were the same among men with and without bone disease. Analysis of postoperative DXA scans revealed that gains in postparathyroidectomy bone density were significantly greater in men than in women at all anatomic testing sites. In men, lowest T scores improved by a mean ± SEM of +0.35 ± 0.09 compared with +0.098 ± 0.035 in women (P = .009). Men were 4 times less likely than women to have continued bone loss after parathyroidectomy. Conclusions: Clinical and laboratory parameters cannot identify men with hyperparathyroidism who have bone loss, illustrating the need for routine DXA screening. Despite this, DXA remains underused. Improved screening practices will favorably effect men's health.",
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AB - Objective: To define the scope of bone disease among men referred for parathyroidectomy and to document bone density screening trends in this high-risk population. Methods: Clinical data were analyzed from a prospectively maintained database of 1000 patients undergoing parathyroidectomy for sporadic primary hyperparathyroidism at the Cleveland Clinic between 2000 and 2006. Information collected included demographics, reason for referral, body mass index, intraoperative findings, preoperative and postoperative laboratory values (serum calcium, phosphorus, parathyroid hormone, 25-hydroxyvitamin D, and 24-hour urinary calcium excretion), and preoperative and postoperative dual-energy x-ray absorptiometry (DXA) findings. Results: Of the 1000 patients, 243 (24%) were men. As with women, bone health-related issues were the most common reason for referral (32%). In 2000, only 12% of men had preoperative DXA scans; this rose to 42% by 2005. The frequency of prereferral DXA screening increased throughout the study, but even by 2006, referring physicians did not screen most of their male patients. In 2000, the prevalence of bone disease (osteoporosis or osteopenia) in men was 8%, but with improved screening, this increased to 26%, approaching the 34% rate in women. Preoperative and postoperative levels of calcium, parathyroid hormone, phosphorus, 24-hour urinary calcium, and 25-hydroxyvitamin D were the same among men with and without bone disease. Analysis of postoperative DXA scans revealed that gains in postparathyroidectomy bone density were significantly greater in men than in women at all anatomic testing sites. In men, lowest T scores improved by a mean ± SEM of +0.35 ± 0.09 compared with +0.098 ± 0.035 in women (P = .009). Men were 4 times less likely than women to have continued bone loss after parathyroidectomy. Conclusions: Clinical and laboratory parameters cannot identify men with hyperparathyroidism who have bone loss, illustrating the need for routine DXA screening. Despite this, DXA remains underused. Improved screening practices will favorably effect men's health.

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