Associations of primary hyperparathyroidism and physical performance, fall- and fracture risk in elderly men - Mr Os Sweden: PHPT-physical performance, falls and fractures in elderly men
(English)Manuscript (preprint) (Other academic)
Introduction: Primary hyperparathyroidism (PHPT) is an endocrine disease associated with deterioration of the skeleton and neuromuscular dysfunction. This study has explored associations between PHPT, physical function and risk of falls and fractures in elderly men.
Method: Serum parameters of calcium homeostasis, physical testing of neuromuscular function (grip strength, time stands, 6 meters walking and 20 cm narrow walking tests), self reported falls during 12 months preceding the testing and self reported fractures were evaluated in 3014 men aged 69 to 81 years in the MrOS Sweden cohort. Subjects were diagnosed with PHPT (n=22) if both albumin adjusted s-calcium and plasma parathyroid hormone (p-iPTH) were above normal in absence of renal failure and vitamin-D insufficiency. To evaluate impact of minor calcium disturbance, suggesting normocalcemic HPT, the total cohort were divided into subjects with inappropriately elevated iPTH (IEP-group), based on above median value of both s-calcium (2.34mmol/L) and iPTH (4.24 pmol/L) ( n=387 minus the 22 with PHPT, in total 365) and subjects with normal calcium homeostasis (controls, n=1848). Group comparisons were made between PHPT-group and controls and IEP-group and controls.
Results: The IEP-group performed inferior in all but one of the muscular functioning tests (all p <0.01, respectively) and the PHPT-group performed inferior in the time stand test (p<0.05). There were no significant group differences in fall or fracture prevalence.
Conclusion: Elderly men with calcium disturbance, suggesting normocalcemic PHPT, had inferior physical performance than men with normal calcium homeostasis but it was not associated with higher fall or fracture prevalence.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-152226OAI: oai:DiVA.org:uu-152226DiVA: diva2:413037