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Bone Density and Body Weight in Hyperparathyroidism
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IN RESPONSE:
Dr. Krakauer asks whether our data support the thesis that primary hyperparathyroidism exerts differential skeletal effects according to the type of bone (cortical or trabecular). We emphasize that the principal conclusion of our report was that unadjusted bone mineral density was normal throughout the skeleton in postmenopausal women with mild primary hyperparathyroidism. Bone mineral density in the hyperparathyroid group tends to be slightly lower at predominantly cortical sites and slightly higher at predominantly trabecular sites; however, none of these trends is statistically significant, and larger studies are necessary to determine whether these trends are real. If present, any differences from normal values are small. Our results contrast with the substantial reduction in proximal forearm bone mineral density reported in most single-photon absorptiometry studies in patients with primary hyperparathyroidism [1]. These studies were probably subject to artefactual underestimation of bone mineral density by a failure to correct for increased soft-tissue adiposity over the measurement site in hyperparathyroid patients.
Because our data were compared with those from normal persons, it is unlikely that expressing them as a percentage of normal would influence our conclusions in any way.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
