{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:20:13Z","timestamp":1783488013949,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T00:00:00Z","timestamp":1381190400000},"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":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with \u201casymptomatic\u201d primary hyperparathyroidism (PHPT) often describe improvement after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated muscle and balance function, quality of life (QoL), and well\u2010being in 58\u00a0PHPT patients and 58 population\u2010based matched controls in a cross\u2010sectional study. We tested whether patients considered \u201casymptomatic\u201d according to international guidelines have functional impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age of the patients and controls was 59 years, and 47 (81 %) were women. Patients had higher levels of plasma PTH and ionized calcium. Creatinine and 25\u2010hydroxyvitamin D levels did not differ between groups. Altogether, 16 (28 %) patients were \u201casymptomatic.\u201d Compared with controls, PHPT was associated with significantly lower QoL in all eight domains of the short form\u201036 questionnaire, lower well\u2010being (WHO Five Well\u2010Being Index; <jats:italic>p<\/jats:italic> &lt; 0.001), and impaired postural stability during normal standing with eyes open (<jats:italic>p<\/jats:italic> &lt; 0.05) or closed (<jats:italic>p<\/jats:italic> &lt; 0.001). Maximum isometric muscle strength was reduced in both upper (<jats:italic>p<\/jats:italic> &lt; 0.01) and lower (<jats:italic>p<\/jats:italic> &lt; 0.001) extremities. Physical performance was decreased during 10 repeated chair stands (<jats:italic>p<\/jats:italic> &lt; 0.001) and time to walk 3\u00a0m forward and back (<jats:italic>p<\/jats:italic> &lt; 0.05). Restricting analyses to \u201casymptomatic\u201d patients showed significantly lower muscle strength at knee extension and flexion and impaired postural stability than in matched controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PHPT is associated with deleterious effects on muscles and QoL. Impairments also apply to patients with mild disease, normally considered \u201casymptomatic.\u201d This may explain why \u201casymptomatic\u201d patients report improvements following surgery. The impaired muscle function may contribute to increased fracture risk independent of bone mineral density.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2273-5","type":"journal-article","created":{"date-parts":[[2013,10,7]],"date-time":"2013-10-07T18:56:20Z","timestamp":1381172180000},"page":"549-557","source":"Crossref","is-referenced-by-count":26,"title":["Muscle Function Is Impaired in Patients With \u201cAsymptomatic\u201d Primary Hyperparathyroidism"],"prefix":"10.1002","volume":"38","author":[{"given":"Lars","family":"Rolighed","sequence":"first","affiliation":[{"name":"Department of Surgery P Aarhus University Hospital Tage Hansens Gade 2 8000 Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Kristine","family":"Amstrup","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism MEA Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Frederik 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