{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T23:35:57Z","timestamp":1785281757762,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,4,18]],"date-time":"2014-04-18T00:00:00Z","timestamp":1397779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,4,18]],"date-time":"2014-04-18T00:00:00Z","timestamp":1397779200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Primary hyperparathyroidism (PHPT) results in increased bone turnover, resulting in bone mineral density (BMD) reduction and a predisposition towards fractures. Parathyroidectomy (PTX) is the only definitive cure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The primary goals of this study were to investigate the impact of PTX on BMD in patients with PHPT and to identify factors associated with post\u2010operative BMD improvement using a multivariate model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 1999 and 2010, a total of 757 patients underwent PTX for treatment of PHPT; 123 patients had both a pre\u2010 and a post\u2010operative dual\u2010energy X\u2010ray absorptiometry (DEXA) scan. A prospective database was queried to obtain information about patient demographics, medications, comorbidities, and pre\u2010 and post\u2010operative laboratory values. A Cox regression model was used to stratify patients and to identify factors that independently predict BMD response following PTX in this patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, mean percent change in BMD was +12.31 % at the spine, +8.9 % at the femoral neck (FN), and +8.5 % at the hip, with a mean follow\u2010up of 2.3 \u00b1 1.5 years. A total of 101 (82.1 %) patients had BMD improvement at their worst pre\u2010operative site. In patients who improved, 69.9 % (<jats:italic>n<\/jats:italic> = 86) had &gt;5 % increase. Factors associated with BMD improvement at the worst pre\u2010operative site were as follows: male gender (hazard ratio [HR] 2.29; 95 % confidence interval [CI] 1.54\u20134.21); pre\u2010operative BMD with T\u2010score less than \u22122.0 (HR 1.89; 95 % CI 1.11\u20132.39); age &lt;55 years (HR 1.74; 95 % CI 1.14\u20132.25); BMD DEXA scan at &gt;2.5 years post\u2010operatively (HR 1.71; 95 % CI 1.09\u20132.17); history of previous fracture (HR 1.24; 95 % CI 1.05\u20131.92); and private insurance (HR 1.18; 95 % CI 1.06\u20132.1). The use of bisphosphonates, estrogens, vitamin D supplementation, or tobacco; obesity; history of previous PTX, serum calcium or parathyroid hormone levels were not independently associated with post\u2010operative BMD improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Osteoporosis is one of the established National Institutes of Health criteria for PTX in asymptomatic patients with PHPT, but BMD improvement is not consistently seen during the post\u2010operative period. Gender, age, more severe pre\u2010operative bone disease, and insurance status were all predictors for greater BMD improvement following PTX. Further studies with a rigorous post\u2010operative BMD regimen are needed in order to validate these results.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2555-6","type":"journal-article","created":{"date-parts":[[2014,4,18]],"date-time":"2014-04-18T01:53:29Z","timestamp":1397786009000},"page":"1268-1273","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Predictors of Bone Mineral Density Improvement in Patients Undergoing Parathyroidectomy for Primary Hyperparathyroidism"],"prefix":"10.1002","volume":"38","author":[{"given":"Jyotirmay","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Surgery Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina S.","family":"Itum","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis","family":"Moss","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Chun\u2010Li","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,18]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002\u2010021370"},{"issue":"7","key":"e_1_2_6_3_2","first-page":"39","article-title":"Skeletal effect of natural early menopause","volume":"33","author":"Francucci CM","year":"2010","journal-title":"J Endocrinol Invest"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7041.1254"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002\u2010021370"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910213411701"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S8756\u20103282(99)00207\u20100"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102796.2005.01600.x"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.80.3.723"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP.14.7.820"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2012.08.015"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109720\u20108"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.1999.14.10.1700"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2011.12.046"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010004\u20107274\u2010y"},{"key":"e_1_2_6_16_2","unstructured":"The Lewin Group Inc(2007)Assessing the costs of DXA services in the office\u2010based setting. 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