{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:39:02Z","timestamp":1778758742143,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2008,9,2]],"date-time":"2008-09-02T00:00:00Z","timestamp":1220313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bone mineral density is one parameter used to decide whether patients with primary hyperparathyroidism (PHPT) should undergo parathyroidectomy. However, the influence of bone mineral density and parathyroidectomy on subsequent fracture risk is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors conducted a retrospective cohort study of patients with PHPT based on administrative discharge abstract data. The dual energy x\u2010ray absorptiometry (DEXA) scan T\u2010scores at the femur were collected by chart review, and 10\u2010year fracture\u2010free survival (FFS) was the main outcome measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 533 patients were identified, most of them \u2265 50 years old (89%) and female (87%). Seventeen percent of the patients were black. Mean initial calcium, parathormone, and creatinine levels were 11.1\u00a0mg\/dl, 116 pg\/ml, and 0.9\u00a0mg\/dl, respectively. Parathyroidectomy was performed in 159 (30%) patients, and 374 (70%) were observed. The 10\u2010year FFS after PHPT diagnosis was 94% in patients treated with parathyroidectomy and 81% in those observed (<jats:italic>p<\/jats:italic> = 0.006). Compared to observation, parathyroidectomy improved the 10\u2010year FFS by 9.1% (<jats:italic>p<\/jats:italic> = 0.99), 12% (<jats:italic>p<\/jats:italic> = 0.92), and 12% (<jats:italic>p<\/jats:italic> = 0.02) in patients with normal bones (T\u2010score \u2265 \u22121.0), osteopenia (T\u2010score \u2264 \u22121.0, \u2265 \u22122.5), and osteoporosis (T\u2010score &lt; \u22122.5), respectively. On multivariate analysis, parathyroidectomy was independently associated with decreased fracture risk (HR = 0.41; 95%CI 0.18, 0.93), whereas non\u2010black race (HR = 2.94; 95%CI 1.04, 8.30) and T\u2010score &lt; \u22122.5 (HR = 2.29; 95%CI 1.08, 4.88) remained independently associated with increased fracture risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Parathyroidectomy decreases the risk of fracture in patients with normal, osteopenic, and osteoporotic bones. The largest impact from parathyroidectomy is in patients with osteoporosis. The highest risk of fracture is in non\u2010blacks and in patients with osteoporosis.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-008-9720-8","type":"journal-article","created":{"date-parts":[[2008,9,1]],"date-time":"2008-09-01T19:01:41Z","timestamp":1220295701000},"page":"406-411","source":"Crossref","is-referenced-by-count":40,"title":["Effect of Bone Mineral Density and Parathyroidectomy on Fracture Risk in Primary Hyperparathyroidism"],"prefix":"10.1002","volume":"33","author":[{"given":"Lindi H.","family":"VanderWalde","sequence":"first","affiliation":[{"name":"Department of Surgery Kaiser Permanente Los Angeles Medical Center 4760 Sunset Boulevard 90027 Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u2010Lu Amy","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Research and Evaluation Kaiser Permanente Regional Offices 100 S. Los Robles, 2nd Floor 91101 Pasadena CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip I.","family":"Haigh","sequence":"additional","affiliation":[{"name":"Department of Surgery Kaiser Permanente Los Angeles Medical Center 4760 Sunset Boulevard 90027 Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,9,2]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP.11.1.49"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102265.2003.01722.x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010004\u20107274\u2010y"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102796.2005.01600.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.06.059"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.0954\u20106820.2003.01237.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.9.885"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(92)90133\u20108"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.24.2077"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003\u2010030908"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000048935"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-3-200502010-00007"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006\u20101836"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007\u20100219"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000120072.85692.a7"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2006.07.032"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-008-9720-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-008-9720-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-008-9720-8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T19:36:23Z","timestamp":1703619383000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-008-9720-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,9,2]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009,3]]}},"alternative-id":["10.1007\/s00268-008-9720-8"],"URL":"https:\/\/doi.org\/10.1007\/s00268-008-9720-8","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,9,2]]}}}