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Changes in 3-dimensional bone structure indices in hypoparathyroid patients treated with PTH(1-84): A randomized controlled study.
MedLine Citation:
PMID:  22161686     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Hypoparathyroidism (hypoPT) is characterized by a state of low bone turnover and high bone mineral density (BMD) despite conventional treatment with calcium supplements and active vitamin D analogues. In order to assess effects of PTH substitution therapy on 3-dimensional bone structure, we randomized 62 patients with hypoPT into 24 weeks of treatment with either PTH(1-84) 100 Dg/d s.c. or similar placebo, as an add-on therapy. MicroCT was performed on 44 iliac crest bone biopsies (23 on PTH treatment) obtained after 24 weeks of treatment. Compared with placebo, PTH caused a 27% lower trabecular thickness (p<0.01) and 4% lower trabecular bone tissue density (p<0.01), whereas connectivity density was 34% higher (p<0.05). Trabecular tunnelling was evident in 11 (48%) of the biopsies from the PTH-group. Patients with tunnelling had significantly higher levels of biochemical markers of bone resorption and formation. At cortical bone, number of Haversian canals per area was 139% higher (p=0.01) in PTH-treated causing a tendency towards an increased cortical porosity (p=0.09). At different sub-regions of the hip areal and volumetric BMD, as assessed by DXA and QCT, decreased significantly by 1-4% in PTH-treated. However, at the lumbar spine aBMD decreased by 1.8% (p<0.05), whereas vBMD increased by 12.8% (p=0.02) in the PTHcompared with the placebo-group. © 2011 American Society for Bone and Mineral Research.
Authors:
Tanja Sikjaer; Lars Rejnmark; Jesper Skovhus Thomsen; Anna Tietze; Annemarie Brüel; Gratien Andersen; Leif Mosekilde
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-8
Journal Detail:
Title:  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research     Volume:  -     ISSN:  1523-4681     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610640     Medline TA:  J Bone Miner Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Bone and Mineral Research.
Affiliation:
Department of Metabolism and Internal Medicine, MEA, Aarhus University Hospital, Aarhus, Denmark. Tanja.sikjaer@gmail.com.
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