24-hour Urine Calcium Predicts Reduced Fracture Incidence and Improved Bone Mineral Density After Surgery for Primary Hyperparathyroidism
Main finding · Fracture incidence after surgery by preoperative 24-hour urine calciumResult — go to the resultIncidence rate ratio 0.29 95% CI 0.11–0.73Authors' conclusion
Twenty-four-hour urine calcium is the most important biochemical variable to predict a decreased fracture incidence and improved bone mineral density after surgery for pHPT.
Study context
- Population
- Patients with successful parathyroidectomy for PHPT and population controls matched on sex, age and municipality; Swedish registers; tertiary referral centermatched cohort
- Participants
- 709 vs 2,112
- Exposure
- PHPT patients after parathyroidectomy vs matched controls; predictors of fracture and BMD
- Primary hyperparathyroidism (pHPT)n = 709
- Controlsn = 2,112reference
- Outcome
- Fracture incidence; absolute change and ≥2.77% increase in BMD of femoral neck, L2-L4 and distal third of radius
- Follow-up
- 1-year follow-up
Methodological detailsprospectively collected surgical cohort, matched population controls, tertiary referral center, register-linked
- Prospectively collected surgical cohort
- Matched population controls
- Tertiary referral center
- Register-linked
Main finding
As reported in the abstract
Fracture incidence after surgery by preoperative 24-hour urine calcium
Incidence rate ratio
0.29
95% CI 0.11–0.73
Highest tertile 220- mg/d
IRR 0.29 (95% CI 0.11–0.73)
Observational data: associations, not effects.
Further findings
BMD recovery after surgery
- Serum and 24-hour urine calcium, PTH, osteocalcin and adenoma weight all associated with BMD recovery
Original publication
24-hour Urine Calcium Predicts Reduced Fracture Incidence and Improved Bone Mineral Density After Surgery for Primary Hyperparathyroidism. J Clin Endocrinol Metab. Published 27 February 2024. doi:10.
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