Vertebral Fracture Assessment in postmenopausal women with post-surgical hypoparathyroidism.

Abstract

CONTEXT\nHypoparathyroidism is a rare endocrine disorder whose skeletal features include suppression of bone turnover, greater volume and width of the trabecular compartment. Few and inconsistent data are available on the prevalence of vertebral fractures (VF).\n\n\nOBJECTIVE\nTo evaluate the prevalence of VF assessed by vertebral fracture assessment (VFA) in postmenopausal women with chronic post-surgical hypoparathyroidism.\n\n\nDESIGN\nCross-sectional study.\n\n\nSETTING\nAmbulatory referral center.\n\n\nPATIENTS OR OTHER PARTICIPANTS\nFifty postmenopausal women (mean age 65.4 ± 9 years) with chronic post-surgical hypoparathyroidism and 40 age-matched healthy postmenopausal women (mean age 64.2 ± 8.6).\n\n\nMAIN OUTCOME MEASURES\nLumbar spine, femoral neck and total hip BMD were measured by dual X-ray absorptiometry (DXA) (Hologic Inc., USA) in all subjects. Site-matched spine TBS was calculated by TBS iNsight (Medimaps, Switzerland). Assessment of VF was made by VFA (iDXA, Lunar GE, USA) using the semiquantitative method and the algorithm-based qualitative assessment.\n\n\nRESULTS\nAll-site BMD values were higher in the hypoparathyroid vs the control group. By VFA, we observed a 16% prevalence of VF in hypoparathyroid women vs 7.5% in control subjects. Among those with hypoparathyroidism who fractured, 5 (62.5%) had grade 1 wedge, 2 (25%) had grade 2 wedge, and 1 (12.5%) grade 2 wedge and grade 2 biconcave VF. In the hypoparathyroid group, among those with VFs, 57% had symptoms of hypoparathyroidism 32% among those without VF.\n\n\nCONCLUSION\nWe demonstrate for the first time that in postmenopausal women with chronic postsurgical hypoparathyroidism, VFs are demonstrable by VFA despite normal BMD.