Preoperative Thoracic Muscle Mass Predicts Bone Density Change After Parathyroidectomy in Primary Hyperparathyroidism

被引:0
|
作者
Burm, Seung Won [1 ]
Hong, Namki [1 ]
Lee, Seunghyun [1 ]
Kim, Gi Jeong [2 ]
Hwang, Sang Hyun [3 ]
Jeong, Jongju [4 ]
Rhee, Yumie [1 ]
机构
[1] Yonsei Univ, Severance Hosp, Endocrine Res Inst, Dept Internal Med,Coll Med, Seoul 03722, South Korea
[2] Yonsei Univ, Severance Hosp, Dept Pathol, Coll Med, Seoul 03722, South Korea
[3] Yonsei Univ, Severance Hosp, Dept Nucl Med, Coll Med, Seoul 03722, South Korea
[4] Yonsei Univ, Severance Hosp, Dept Surg, Coll Med, Seoul 03722, South Korea
来源
关键词
primary hyperparathyroidism; parathyroidectomy; bone mineral density; muscle mass; parathyroid hormone; ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM; MINERAL DENSITY; STRENGTH; HORMONE; METABOLISM; GUIDELINES; MANAGEMENT; SARCOPENIA; PROTEIN;
D O I
10.1210/clinem/dgac083
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context Predicting bone mineral density (BMD) gain after parathyroidectomy may influence individualized therapeutic approaches for treating patients with primary hyperparathyroidism (PHPT). Objective This study aimed to assess whether skeletal muscle mass data could predict BMD change after parathyroidectomy in patients with PHPT. Methods This retrospective study collected data from 2012 to 2021 at Severance Hospital, Seoul, Korea. A total of 130 patients (mean age, 64.7 years; 81.5% women) with PHPT who underwent parathyroidectomy were analyzed. Thoracic muscle volume (T6-T7 level) was estimated using noncontrast parathyroid single photon emission computed tomography/computed tomography (SPECT/CT) scans and an automated deep-learning-based software. The primary outcome assessed was the change in femoral neck BMD (FNBMD, %) 1 year after parathyroidectomy. Results The median degree of FNBMD change after parathyroidectomy was + 2.7% (interquartile range: -0.9 to + 7.6%). Elevated preoperative PTH level was associated with lower thoracic muscle mass (adjusted beta: -8.51 cm(3) per one log-unit PTH increment, P = .045) after adjusting for age, sex, body mass index (BMI), and baseline FNBMD. One SD decrement in thoracic muscle mass was associated with lesser FNBMD (adjusted beta: -2.35%, P = .034) gain and lumbar spine BMD gain (adjusted beta: -2.51%, P = .044) post surgery after adjusting for covariates. Conclusion Lower thoracic skeletal muscle mass was associated with elevated preoperative PTH levels in patients with PHPT. Lower skeletal muscle mass was associated with lesser BMD gain after parathyroidectomy, independent of age, sex, BMI, preoperative BMD, and PTH level.
引用
收藏
页码:E2474 / E2480
页数:7
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