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Primary hyperparathyroidism and associated morbidity during menopausal transition: three years follow-up
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
2011 (English)In: Acta Endocrinologica, ISSN 1841-0987, E-ISSN 1843-066X, Vol. 7, no 2, 249-262 p.Article in journal (Refereed) Published
Abstract [en]

Context. Postmenopausal women are at risk of developing primary hyperparathyroidism (PHPT) and the underlying disturbance in calcium homeostasis is suspected to have been established for some time prior to diagnosis. Objectives. Pre-menopausal women with disturbance in calcium homeostasis suggesting PHPT have been evaluated during menopausal transition regarding associated morbidity. Design and subjects. Premenopausal women, 40 to 50 years of age, were screened with parameters of calcium homeostasis in conjunction with routine mammography during 2002-2003. Those who fulfilled preset criteria of mild PHPT (cases) (n=173) were matched to controls (n=193). The pre/perimenopausal women were investigated for the prevalence of PHPT in association with skeletal changes, morbidity and impact on quality of life (base-line data already published). They have now been re-evaluated regarding different health aspects after three years follow-up. Results. The cases still had lower bone mineral density (BMD) in total hip, femoral neck and distal third of radius than controls (p<0.05) after three years followup. Time of follow-up, menopausal status, and weight affected BMD independently. Conclusion. Middle-aged women with mild disturbances of calcium homeostasis suggesting early PHPT, had lower BMD in the hip and radius, but the decline in BMD was not accelerated during menopausal transition.

Place, publisher, year, edition, pages
2011. Vol. 7, no 2, 249-262 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-152180DOI: 10.4183/aeb.2011.249OAI: oai:DiVA.org:uu-152180DiVA: diva2:412802
Available from: 2011-04-26 Created: 2011-04-26 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Primary Hyperparathyroidism: Prevalence and Associated Morbidity in Middle-Aged Women and Elderly Men
Open this publication in new window or tab >>Primary Hyperparathyroidism: Prevalence and Associated Morbidity in Middle-Aged Women and Elderly Men
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Primary hyperparathyroidism (PHPT) is a common endocrine disease, existing in both genders and in all age groups. Postmenopausal women are at particular risk of developing the disease and estrogen decline after menopause is suggested to affect the progress. Although PHPT is mild in its presentation with subtle or no subjective symptoms, it is associated with an increased risk of associated morbidity and also mortality i.e cardiovascular complications, psychiatric instability, concomitant metabolic abnormalities, obesity and decrease in bone mineral density. The current cure is surgical removal of the diseased gland/s, but other medical alternatives have been investigated. The disease is thoroughly explored in postmenopausal women but less is known about other populations groups.

Since progression of the disease generally is slow, the underlying disturbance of the calcium homeostasis can be suspected to have been established a long time prior to diagnose with potential to affect associated morbidity. The general aim of this thesis is to clarify the expression of PHPT in premenopausal women and in elderly men and to explore how frequent the disease in these populations occurs. The women and men were investigated through population-based studies.

Baseline data and prevalence of PHPT in premenopausal women age 40-50 years were studied (Paper I), the prevalence was 5.1% in this population and was associated with decreased bone mineral density and associated obesity. In a three years follow up of the female cohort, the effects of menopausal transition and associated morbidity was investigated (Paper II). The prevalence and expression of PHPT in men between 69 and 81 years and impact on bone mineral density, physical performance, fall and fracture prevalence was explored through data from Mr Os Sweden (Papers III and IV). In this population prevalence of PHPT was 0.73% and associated with lower bone mineral density and inferior physical performance.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 65 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 678
Keyword
Primary hyperparathyroidism, menopausal, bone mineral density, physical performance, parathyroid hormone
National Category
Medical and Health Sciences
Research subject
Epidemiology
Identifiers
urn:nbn:se:uu:diva-152270 (URN)978-91-554-8097-4 (ISBN)
Public defence
2011-06-11, Grönwallssalen, Akademiska sjukhuset, ingång 70, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-05-20 Created: 2011-04-27 Last updated: 2011-07-01Bibliographically approved

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