SHORT-TERM EFFECT OF PARATHYROIDECTOMY ON BIOCHEMICAL MARKERS IN PRIMARY AND SECONDARY HYPERPARATHYROIDISM

This study has been carried out in order to evaulate several bone meta bolic markers after parathyroidectomy in patients with primary hyperpa rathyroidism (PHP) and secondary hyperparathyroidism (SHP). The subjec ts studied were 6 patients with PHP (5 females, 1 male, aged 64-83 yea rs) and 5 patients with SHP on chronic maintenance hemodialysis with s keletal symptoms (2 females, 3 males, aged 57-67 years). In PHP, serum alkaline phosphatase (ALP) and procollagen type I carboxy-terminal pr opeptides (PICP) levels showed a trend to increase gradually after par athyroidectomy, changes which were statistically significant (ALP, p = 0.0375; PICP, p = 0.0006). The serum bone Gla protein (BGP) level sho wed no significant change throughout the pre- and postoperative period s (p = 0.7512). Urinary pyridinoline (Pyr.) and deoxypyridinoline (DPy r.) 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 incom plete parathyroid resection showed a tendency to increase. Individual values of serum BGP and PICP increased after parathyroidectomy in 3 pa tients with complete parathyroid resection but not in the 2 patients w ith incomplete parathyroid resection. Individual values of the serum c arboxyterminal pyridinoline cross-linked telopeptide of type I collage n (ICTP) level showed no certain trend. The results obtained after sur gery indicate that there is a positive uncoupling of the two processes of bone remodeling, and serum Bone formation PICP and urinary pyridin ium cross-links are good specific markers for the Bone resorption eval uation of potential recovery of bone damage after parathyroidectomy.