Estrogen replacement may be an alternative to parathyroid surgery for the treatment of osteoporosis in elderly postmenopausal women presenting with primary hyperparathyroidism: A preliminary report
Estrogen replacement may be an alternative to parathyroid surgery for the treatment of osteoporosis in elderly postmenopausal women presenting with primary hyperparathyroidism: A preliminary report
复制标题
雌激素替代可能是甲状旁腺手术的替代方案，用于治疗患有原发性甲状旁腺功能亢进症的老年绝经后妇女的骨质疏松症：初步报告
DOI：
10.1007/bf01623394
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发表时间：
2005
影响因子：
4
通讯作者：
R. Smart
中科院分区：
文献类型：
--
作者：
Terrence H. Diamond;A. Ng;S. Levy;C. Magarey;R. Smart
Parathyroid surgery is indicated in patients presenting with primary hyperparathyroidism (PHPT) and osteoporosis (defined as bone mineral density more than 2 standard deviations below normal). Many are elderly women with complex medical problems, either unwilling or considered unfit for surgery. Estrogen replacement therapy (ERT) may potentially be an alternative form of therapy in this group. We studied 15 consecutive postmenopausal women presenting with PHPT and osteoporosis. Group 1 comprised 5 women who elected to be treated with ERT (conjugated equine estrogen, 0.3–0.625 mg/day). The other 10 women underwent successful parathyroidectomy. These 10 patients were randomly subdivided into group 2 (5 patients who received calcitriol 0.25 µg b.i.d. for 12 months following surgery) and group 3 (5 patients who received elemental calcium 1 g/day for 12 months following surgery). Lumbar spine and femoral neck bone mineral density (BMD) were measured prior to and after 12 months of therapy, using a dual-energy X-ray absorptiometer (Lunar DPX-L). The three groups did not differ with respect to their ages (group mean 71.8 years), or baseline serum calcium (group mean 2.77 mmol/l), serum parathyroid hormone (group mean 11.0 pmol/l), lumbar spine BMD (group mean 0.93 g/cm2) and femoral neck BMD (group mean 0.73 g/cm2). Serum calcium normalized in all patients who underwent surgery and none developed hypoparathyroidism. A non-significant decrease in serum calcium was seen in patients treated with ERT only. Lumbar spine (+5.3% per year; 95% CI, 1.1% to 9.6%) and femoral neck BMD (+5.5% per year; 95% CI, −2.1% to 13.2%) increased significantly after 12 months of ERT (p<0.001 compared with pre-therapy values). These increases in BMD did not differ significantly from those in patients who underwent successful parathyroidectomy followed by either calcitriol therapy or calcium replacement (lumbar spine BMD increase of +6.2% per year, 95% CI 3.1% to 9.4%; and femoral neck BMD increase of +3% per year, 95% CI 0 to 6%). In summary, increases in lumbar spine and femoral neck BMD occur following treatment of PHPT. ERT appeared as effective as parathyroidectomy (combined with either calcitriol or calcium supplements) for the treatment of osteoporosis in elderly postmenopausal women presenting with PHPT.
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原发性甲状旁腺功能亢进症甲状旁腺切除术后骨密度增加。
DOI：
10.1210/jcem.80.3.7883824
发表时间：
1995
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Silverberg,SJ;Gartenberg,F;Jacobs,TP;Shane,E;Siris,E;Staron,RB;McMahon,DJ;Bilezikian,JP
通讯作者：
Bilezikian,JP
未经治疗的原发性甲状旁腺功能亢进症的骨密度和生化指标的纵向测量。
DOI：
10.1210/jcem.80.3.7883823
发表时间：
1995
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Silverberg,SJ;Gartenberg,F;Jacobs,TP;Shane,E;Siris,E;Staron,RB;Bilezikian,JP
通讯作者：
Bilezikian,JP
结合雌激素治疗绝经后妇女甲状旁腺功能亢进症。
影响因子：
39.2
作者：
Marcus,R;Madvig,P;Crim,M;Pont,A;Kosek,J
通讯作者：
Kosek,J
内分泌功能障碍对中轴和附肢骨骼的不同影响。
DOI：
10.1172/jci110570
发表时间：
1982
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
Seeman,E;Wahner,HW;Offord,KP;Kumar,R;Johnson,WJ;Riggs,BL
通讯作者：
Riggs,BL