{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:09:22Z","timestamp":1790856562967,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T00:00:00Z","timestamp":1495670400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100005754","name":"Sahlgrenska Universitetssjukhuset","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005754","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2003<\/jats:title>\n                  <jats:p>Mild primary hyperparathyroidism (PHPT) is known to affect the skeleton, even though patients usually are asymptomatic. Treatment strategies have been widely discussed. However, long-term randomized studies comparing parathyroidectomy to observation are lacking. The objective was to study the effect of parathyroidectomy (PTX) compared with observation (OBS) on bone mineral density (BMD) in g\/cm2 and T-scores and on biochemical markers of bone turnover (P1NP and CTX-1) in a prospective randomized controlled study of patients with mild PHPT after 5 years of follow-up. Of 191 patients with mild PHPT randomized to either PTX or OBS, 145 patients remained for analysis after 5 years (110 with validated DXA scans). A significant decrease in P1NP (p\u2009&amp;lt;\u20090.001) and CTX-1 (p\u2009&amp;lt;\u20090.001) was found in the PTX group only. A significant positive treatment effect of surgery compared with observation on BMD (g\/cm2) was found for the lumbar spine (LS) (p\u2009=\u20090.011), the femoral neck (FN) (p\u2009&amp;lt;\u20090.001), the ultradistal radius (UDR) (p\u2009=\u20090.042), and for the total body (TB) (p\u2009&amp;lt;\u20090.001) but not for the radius 33% (Rad33), where BMD decreased significantly also in the PTX group (p\u2009=\u20090.012). However, compared with baseline values, there was no significant BMD increase in the PTX group, except for the lumbar spine. In the OBS group, there was a significant decrease in BMD (g\/cm2) for all compartments (FN, p\u2009&amp;lt;\u20090.001; Rad33, p\u2009=\u20090.001; UDR, p\u2009=\u20090.006; TB, p\u2009&amp;lt;\u20090.001) with the exception of the LS, where BMD was stable. In conclusion, parathyroidectomy improves BMD and observation leads to a small but statistically significant decrease in BMD after 5 years. Thus, bone health appears to be a clinical concern with long-term observation in patients with mild PHPT. \u00a9 2017 American Society for Bone and Mineral Research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/jbmr.3177","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T17:22:52Z","timestamp":1495732972000},"page":"1907-1914","source":"Crossref","is-referenced-by-count":81,"title":["Effect of Surgery Versus Observation: Skeletal 5-Year Outcomes in a Randomized Trial of Patients With Primary HPT (the SIPH Study)"],"prefix":"10.1093","volume":"32","author":[{"given":"Karolina","family":"Lundstam","sequence":"first","affiliation":[{"name":"Department of Radiology, Institute of Clinical SciencesSahlgrenska Academy at the University of Gothenburg, Sahlgrenska University HospitalGothenburgSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansgar","family":"Heck","sequence":"additional","affiliation":[{"name":"Section of Specialized EndocrinologyOslo University Hospital, and Faculty of Medicine, University of OsloOsloNorway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Godang","sequence":"additional","affiliation":[{"name":"Section of Specialized EndocrinologyOslo University Hospital, and Faculty of Medicine, University of OsloOsloNorway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Mollerup","sequence":"additional","affiliation":[{"name":"Clinic of Breast and Endocrine Surgery, Center HOCCopenhagen University Hospital, RigshospitaletCopenhagenDenmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Baranowski","sequence":"additional","affiliation":[{"name":"St Olavs HospitalTrondheimNorway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ylva","family":"Pernow","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Department of Endocrinology, Karolinska InstitutetKarolinska University HospitalStockholmSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turid","family":"Aas","sequence":"additional","affiliation":[{"name":"Department of Breast and Endocrine SurgeryHaukeland University HospitalBergenNorway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Hessman","sequence":"additional","affiliation":[{"name":"Department of Surgical SciencesUniversity of UppsalaUppsalaSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thord","family":"Ros\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes, and MetabolismSahlgrenska University HospitalGothenburgSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rgen","family":"Nordenstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and SurgeryKarolinska 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