FRACTURE INCIDENCE IN POSTMENOPAUSAL WOMEN WITH PRIMARY HYPERPARATHYROIDISM

Background. The association of bone loss and increased fractures in po stmenopausal women with minimally symptomatic hyperparathyroidism has not been clearly defined. This study was done to determine the frequen cy of fractures in postmenopausal women with hyperparathyroidism. Meth ods. Forty-six postmenopausal women who had undergone parathyroidectom y for hyperparathyroidism during a 5-year period (1986 to 1991) were i nterviewed, and their medical records were examined to determine their fracture history. Forty-four postmenopausal women without hyperparath yroidism were contacted by random digit dialing and interviewed as con trols. Results. The groups were comparable with regard to age, weight, height, race, and age at menopause. Medical conditions and medication use were also similar, except for more reports of hypothyroidism min the hyperparathyroidism group (p = 0.05). Only 13% of women presented for treatment because of bone concerns, either fractures (9%) or low b one density (4%). However on interview, 48% of the patients with hyper parathyroidism reported fractures compared with 25% of the controls (p = 0.02), a difference that remained even when those presenting with b one disease were excluded (p = 0.05). Of those with fractures, multipl e fractures occurred in 36% of patients with hyperparathyroidism compa red with 9% of controls and generally occurred after minor rather than major trauma (92% versus 45%, p = 0.002). Appendicular skeletal sites were reported for 86% of hyperparathyroidism group's and 92% of contr ol group's fractures. Moreover, 50% of patients with hyperparathyroidi sm reported height loss compared with 27% of the central group (p = 0. 05). Conclusions. This study shows that postmenopausal women with hype rparathyroidism reported more fractures and height loss than the contr ol group, even when patients with hyperparathyroidism who presented be cause of bone disease were excluded.