What is it about?
Patients with hypoparathyroidism have abnormal bone remodelling. We have shown for the first time that despite increased bone density, prevalence of vertebral fractures is increased in these patients likely due to abnormal bone microarchitecture.
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Why is it important?
This is the first study to show that increase in bone mineral density doesn't translate into increased skeletal strength in hypoparathyroid patients. This study not only emphasizes the need for regular screening of vertebral fractures in these patients but also provides future directives for study of the role of parathormone therapy in reversing the abnormal skeletal microarchitecture and fragility.
Perspectives
Hypoparathyroidism is a rare disease characterized by low bone turnover consequent to chronic parathormone deficiency. Though the disease is associated with an increase in bone mineral density, bone microarchitecture is compromised as demonstrated by Quantitative computed tomography and bone histomorphometry. Vertebral fractures are often missed clinically but vertebral morphometry software is highly sensitive in identifying them. We demonstrated an increase in prevalence of vertebral fractures despite increase in bone mineral density in hypoparathyroidism. Thus, these patients require regular screening for vertebral fractures. Further studies are needed to assess the role of parathormone in reversing skeletal microarchitecture abnormalities and improvement in skeletal strength.
Doctor Himika Chawla
All India Institute of Medical Sciences
Read the Original
This page is a summary of: Vertebral fractures and bone mineral density in patients with idiopathic hypoparathyroidism on long term follow-up, The Journal of Clinical Endocrinology & Metabolism, November 2016, Endocrine Society,
DOI: 10.1210/jc.2016-3292.
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