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- Title
Factors associated with vertebral fracture risk in patients with primary hyperparathyroidism.
- Authors
Eller-Vainicher, Cristina; Battista, Claudia; Guarnieri, Vito; Muscarella, Silvana; Palmieri, Serena; Salcuni, Antonio Stefano; Guglielmi, Giuseppe; Corbetta, Sabrina; Minisola, Salvatore; Spada, Anna; Hendy, Geoffrey N.; Cole, David E. C.; Chiodini, Iacopo; Scillitani, Alfredo
- Abstract
Objective: To examine factors, in addition to bone mineral density (BMD), such as the common calcium-sensing receptor (CASR) gene polymorphisms, associated with vertebral fracture (VFx) risk in primary hyperparathyroidism (PHPT). Design and methods: A cross-sectional analysis of 266 Caucasian PHPT seen as outpatients. Serum calcium (sCa) phosphate metabolism parameters were measured. BMD was assessed by dual-energy X-ray absorptiometry (expressed as Z-score) at lumbar spine (Z-LS) and femoral neck, morphometric VFx by radiograph, and CASR A986S/R990G genotypes by PCR amplification and genomic DNA sequencing. Results: Fractured patients (nZ100, 37.6%) had lower sCa (10.8G0.7 mg/dl) and Z-LS BMD (K1.0G1.44), higher age (61G10 years), and prevalence (51%) of R1 S alleles of the CASR A986S single-nucleotide polymorphism (SNP; AS/SS), than those not fractured (nZ166, 11.2G1.0 mg/dl, K0.57G0.97, 58G13 years, and 38% AS/SS, respectively, P!0.05 for all comparisons). Logistic regression, with VFx as dependent variable, showed independent risks associated with increased age (OR 1.03, 95% CI 1.01-1.06, PZ0.006), decreased sCa (OR 1.86, 95% CI 1.28-2.7, PZ0.001), and Z-LS BMD (OR 1.4, 95% CI 1.12-1.7, PZ0.002) and presence of AS/SS (OR 1.8, 95% CI 1.1-2.9, PZ0.05). The presence of two out of three factors (ageR58 years, sCa !10.8 and Z-LS BMD%K1.0, and AS/SS genotype) gave an overall OR of 4.2 (95% CI 2.25-7.85, P!0.0001). Conclusions: In PHPT, VFx is associated positively with age, negatively with sCa and spinal BMD, and presence of at least one copy of the CASR A986S SNP.
- Subjects
VERTEBRAL fractures; RISK factors of fractures; HYPERPARATHYROIDISM; BONE density; CALCIUM-sensing receptors; PATIENTS
- Publication
European Journal of Endocrinology, 2014, Vol 171, Issue 3, p399
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-14-0343