{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:32:29Z","timestamp":1791045149054,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Biochemical cure in normocalcemic primary hyperparathyroidism (nPHPT) is defined as parathyroid hormone (PTH) level normalization 6\u00a0months after parathyroidectomy. However, recent studies show that a significant number of nPHPT patients have persistent PTH elevation postoperatively. We sought to correlate changes in PTH levels with skeletal outcomes after parathyroidectomy in nPHPT patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients who underwent parathyroidectomy at a tertiary referral center for sporadic PHPT between 2010 and 2020 were reviewed. Pre\u2010 and postoperative (6\u00a0months, 18\u00a0months, and last follow\u2010up) laboratory and bone mineral densities (BMD) were recorded. Primary outcome was 18\u2010month postoperative BMD change in the lumbar spine (LS), total hip (TH) and femoral neck (FN) in normocalcemic and hypercalcemic PHPT (hPHPT) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 661 patients included, 68 had nPHPT. nPHPT patients frequently had multigland disease (31% vs. 18%, <jats:italic>p<\/jats:italic>\u2009=\u20090.014), more bilateral cervical explorations (22% vs. 13%, <jats:italic>p<\/jats:italic>\u2009=\u20090.042), and fewer achieved biochemical cure (76% vs. 95%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than hPHPT patients. Twenty\u2010eight nPHPT patients had BMD data for comparison. Overall, nPHPT patients had improvement in the LS (1.84%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and TH (1.64%, <jats:italic>p<\/jats:italic>\u2009=\u20090.014). When stratified by postoperative PTH levels, nPHPT patients with persistent PTH elevation had more BMD improvement at the TH than those who normalized PTH (3.73% vs.\u2009\u2212\u20090.83%, <jats:italic>p<\/jats:italic>\u2009=\u20090.017). There was no difference in improvement at the LS or FN (<jats:italic>p<\/jats:italic>\u2009=\u2009NS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Parathyroidectomy is associated with improved BMD in nPHPT patients with bone disease. Although one in four nPHPT patients had elevated postoperative PTH levels persisting throughout the study, BMD improvement was still seen regardless of postoperative PTH level normalization.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06756-x","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T18:02:30Z","timestamp":1664906550000},"page":"363-370","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism is Associated with Improved Bone Mineral Density Regardless of Postoperative Parathyroid Hormone Levels"],"prefix":"10.1002","volume":"47","author":[{"given":"Michael S.","family":"Lui","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uriel","family":"Clemente\u2010Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danica M.","family":"Vodopivec","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shandel L.","family":"Chang","sequence":"additional","affiliation":[{"name":"McGovern Medical School at The University of Texas Health Science Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya S.","family":"Shirali","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernice L.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Ju","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah B.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G.","family":"Grubbs","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa A.","family":"Guise","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul H.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5933-1005","authenticated-orcid":false,"given":"Nancy D.","family":"Perrier","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center 1400 Pressler Street, Unit 1484 77030 Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","first-page":"S51","article-title":"Differential diagnosis of hypercalcemia","volume":"6","author":"Lafferty FW","year":"1991","journal-title":"J Bone Miner 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September 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 October 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors attest that there are no conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The authors attest that this study complies with the journal\u2019s ethical policies.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}