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1 November 1995 | Volume 123 Issue 9 | Page 732
We recently reported that body weight and fat mass are increased in postmenopausal women with mild, asymptomatic primary hyperparathyroidism [1]. We have now obtained lifetime weight histories from 38 of the hyperparathyroid women and 30 of the controls from our original study. The controls were similar in all respects to the larger group described in the original study. The body weight of the women who developed primary hyperparathyroidism was significantly higher than that of their eucalcemic peers at ages 40 and 60 years (P < 0.001 for both time points) but not at age 20 years (P = 0.18) (Table 1). A similar proportion of patients in each group reported an increase in body weight of more than 5 kg during the last 10 years. LETTER
Body Weight and Bone Mineral Density in Hyperparathyroidism
TO THE EDITOR:
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Because primary hyperparathyroidism rarely occurs in women younger than age 40 years [2], these findings suggest that increased body weight precedes the onset of primary hyperparathyroidism in postmenopausal women. Body weight is an important determinant of bone mineral density [3], and the current findings suggest that as a result of their mild obesity earlier in life, postmenopausal women who develop primary hyperparathyroidism may have had higher than normal bone density before the onset of parathyroid disease. The association between primary hyperparathyroidism and increased body weight is unlikely to be the result of an anabolic effect of parathyroid hormone on adipose tissue. Although ascertainment bias may be responsible for this association, potential biological explanations include an effect of obesity on parathyroid gland function, perhaps mediated by long-standing secondary hyperparathyroidism [4] or by a shared genetic predisposition to both conditions.
Author and Article Information
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References
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TopAuthor & Article InfoReferences |
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1. Grey AB, Evans MC, Stapleton JP, Reid IR. Body weight and bone mineral density in postmenopausal women with primary hyperparathyroidism. Ann Intern Med. 1994; 121:745-9.
2. Palmer M, Jakobsson S, Akerstrom G, Ljunghall S. Prevalence of hypercalcemia in a health survey: a 14-year follow-up study of serum calcium values. Eur J Clin Invest. 1988; 18:39-46.
3. Mazess R, Barden H, Ettinger B, Johnston C, Dawson-Hughes B, Baran D, et al. Spine and femur density using dual-photon absorptiometry in US white women. Bone Min. 1987; 2:211-9.
4. Bell NH, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S. Evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest. 1985; 76:370-3.
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  B Moosgaard, P Vestergaard, L Heickendorff, F Melsen, P Christiansen, and L Mosekilde Plasma 25-hydroxyvitamin D and not 1,25-dihydroxyvitamin D is associated with parathyroid adenoma secretion in primary hyperparathyroidism: a cross-sectional study. Eur. J. Endocrinol., August 1, 2006; 155(2): 237 - 244. [Abstract] [Full Text] [PDF]
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E. Hagstrom, E. Lundgren, J. Rastad, and P. Hellman Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur. J. Endocrinol., July 1, 2006; 155(1): 33 - 39. [Abstract] [Full Text] [PDF]
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 A. Grey, M. Bolland, and I. R. Reid Evaluation and Treatment of Primary Hyperparathyroidism JAMA, December 7, 2005; 294(21): 2699 - 2700. [Full Text] [PDF]
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