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  • Title: Short-term effect of parathyroidectomy on biochemical markers in primary and secondary hyperparathyroidism.
    Author: Hoshino H, Kushida K, Takahashi M, Denda M, Yamazaki K, Yamanashi A, Inoue T.
    Journal: Miner Electrolyte Metab; 1997; 23(2):93-9. PubMed ID: 9252975.
    Abstract:
    This study has been carried out in order to evaluate several bone metabolic markers after parathyroidectomy in patients with primary hyperparathyroidism (PHP) and secondary hyperparathyroidism (SHP). The subjects studied were 6 patients with PHP (5 females, 1 male, aged 64-83 years) and 5 patients with SHP on chronic maintenance hemodialysis with skeletal symptoms (2 females, 3 males, aged 57-67 years). In PHP, serum alkaline phosphatase (ALP) and procollagen type I carboxy-terminal propeptides (PICP) levels showed a trend to increase gradually after parathyroidectomy, changes which were statistically significant (ALP, p = 0.0375; PICP, p = 0.0006). The serum bone Gla protein (BGP) level showed no significant change throughout the pre- and postoperative periods (p = 0.7512). Urinary pyridinoline (Pyr.) and deoxypyridinoline (DPyr.) levels showed rapid decreases after parathyroidectomy (Pyr.; p = 0.0014, DPyr., p = 0.0087). In SHP, individual values of serum ALP in 3 patients with complete parathyroid resection and 1 patient with incomplete parathyroid resection showed a tendency to increase. Individual values of serum BGP and PICP increased after parathyroidectomy in 3 patients with complete parathyroid resection but not in the 2 patients with incomplete parathyroid resection. Individual values of the serum carboxy-terminal pyridinoline cross-linked telopeptide of type I collagen (ICTP) level showed no certain trend. The results obtained after surgery indicate that there is a positive uncoupling of the two processes of bone remodeling, and serum PICP and urinary pyridinium cross-links are good specific markers for the evaluation of potential recovery of bone damage after parathyroidectomy.
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