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Preoperative Thoracic Muscle Mass Predicts Bone Density Change After Parathyroidectomy in Primary Hyperparathyroidism

Authors
 Seung Won Burm  ;  Namki Hong  ;  Seunghyun Lee  ;  Gi Jeong Kim  ;  Sang Hyun Hwang  ;  Jongju Jeong  ;  Yumie Rhee 
Citation
 JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, Vol.107(6) : e2474-e2480, 2022-05 
Journal Title
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
ISSN
 0021-972X 
Issue Date
2022-05
MeSH
Bone Density / physiology ; Female ; Humans ; Hyperparathyroidism, Primary* / complications ; Hyperparathyroidism, Primary* / surgery ; Male ; Middle Aged ; Muscle, Skeletal / diagnostic imaging ; Parathyroid Hormone ; Parathyroidectomy* ; Retrospective Studies
Keywords
bone mineral density ; muscle mass ; parathyroid hormone ; parathyroidectomy ; primary hyperparathyroidism
Abstract
Context: Predicting bone mineral density (BMD) gain after parathyroidectomy may influence individualized therapeutic approaches for treating patients with primary hyperparathyroidism (PHPT).

Objective: This study aimed to assess whether skeletal muscle mass data could predict BMD change after parathyroidectomy in patients with PHPT.

Methods: This retrospective study collected data from 2012 to 2021 at Severance Hospital, Seoul, Korea. A total of 130 patients (mean age, 64.7 years; 81.5% women) with PHPT who underwent parathyroidectomy were analyzed. Thoracic muscle volume (T6-T7 level) was estimated using noncontrast parathyroid single photon emission computed tomography/computed tomography (SPECT/CT) scans and an automated deep-learning-based software. The primary outcome assessed was the change in femoral neck BMD (FNBMD, %) 1 year after parathyroidectomy.

Results: The median degree of FNBMD change after parathyroidectomy was + 2.7% (interquartile range: -0.9 to + 7.6%). Elevated preoperative PTH level was associated with lower thoracic muscle mass (adjusted β: -8.51 cm3 per one log-unit PTH increment, P = .045) after adjusting for age, sex, body mass index (BMI), and baseline FNBMD. One SD decrement in thoracic muscle mass was associated with lesser FNBMD (adjusted β: -2.35%, P = .034) gain and lumbar spine BMD gain (adjusted β: -2.51%, P = .044) post surgery after adjusting for covariates.

Conclusion: Lower thoracic skeletal muscle mass was associated with elevated preoperative PTH levels in patients with PHPT. Lower skeletal muscle mass was associated with lesser BMD gain after parathyroidectomy, independent of age, sex, BMI, preoperative BMD, and PTH level.
Full Text
https://academic.oup.com/jcem/article/107/6/e2474/6527266?login=true
DOI
10.1210/clinem/dgac083
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gi Jeong(김기정)
Lee, Seunghyun(이승현)
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
Hwang, Sang Hyun(황상현) ORCID logo https://orcid.org/0000-0002-8130-6671
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189357
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