PRIMARY HYPERPARATHYROIDISM AND ASSOCIATED MORBIDITY DURING MENOPAUSAL TRANSITION - THREE YEARS FOLLOW-UP

Context. Postmenopausal women are at risk of developing primary hyperparathyroidism (PHPT) and the underlying disturbance in calcium homeostasis is suspected to have been established for some time prior to diagnosis. Objectives. Pre-menopausal women with disturbance in calcium homeostasis suggesting PHPT have been evaluated during menopausal transition regarding associated morbidity. Design and subjects. Premenopausal women, 40 to 50 years of age, were screened with parameters of calcium homeostasis in conjunction with routine mammography during 2002-2003. Those who fulfilled preset criteria of mild PHPT (cases) (n=173) were matched to controls (n=193). The pre/perimenopausal women were investigated for the prevalence of PHPT in association with skeletal changes, morbidity and impact on quality of life (base-line data already published). They have now been re-evaluated regarding different health aspects after three years follow-up. Results. The cases still had lower bone mineral density (MOD) in total hip, femoral neck and distal third of radius than controls (p<0.05) after three years follow-up. Time of follow-up, menopausal status, and weight affected BMD independently. Conclusion. Middle-aged women with mild disturbances of calcium homeostasis suggesting early PHPT, had lower BMD in the hip and radius, but the decline in BMD was not accelerated during menopausal transition.