THE INCIDENCE OF INDOLENT SECONDARY HYPERPARATHYROIDISM (SH) AMONG POSTMENOPAUSAL WOMEN SUFFERING FROM KNEE OSTEOARTHRITIS (KOA). A PROSPECTIVE STUDY.

Abstract

Introduction. This prospective cohort study aimed at the assessment of the incidence of indolent SH among otherwise ‘healthy’ and symptoms’ free postmenopausal women suffering from primary KOA.

Methods. During a period of 23 months (November 2004 – Sepetember 2006), two hundred and forty-two postmenopausal women suffering from primary KOA were enrolled. None of them had suffered any osteoporotic fracture, received any anti-osteoporosis treatment or suffered from any disease interfering with their bone mass/quality. The serum levels of Intact-Parathyroid Hormone (I-PTH), Calcium and Phosphorus were evaluated and Creatinine Clearance was calculated. The latter was performed in order to determine a possible relation between the patients’ renal function and the I-PTH level.

Results. The patients’ mean age was 70,20 years (range: 49–81). The years that had passed since their menopause ranged from 7 to 31 (mean of 18,7 years). The patients were divided into three groups according to their age: Group A (n=41) age < 64 years, Group B (n=140) age 65–74 years and Group C (n=61) age > 75. The overall incidence of SY in all three groups was 35,95% (87 out of 242 patients). Group C patients were most likely to suffer from SY (25 out of 61 patients or 40,98%). The I-PTH values of Group A patients were normal in 27 out of 41 patients (68,85%) and of Group B in 92 out of 140 patients (65,71%). One group B patient suffered from Primary Hyperparathyroidism. No statistically significant relation between the patient’s renal function and the I-PTH level was found.

Discussion/Conclusion. SH appears to be a ‘silent’ epidemic among elderly postmenopausal women. According to our results, women 75 years-old and older are most likely to suffer from SY. One of the main reasons for that seems to be the insufficient calcium and/or vitamin D intake. It is our belief that anti-osteoporosis diagnosis and treatment modalities should be focused on this group of patients.