Abstract
Primary hyperparathyroidism (PHPT) is the leading cause of secondary osteoporosis. Although bone mineral density (BMD) tends to recover after parathyroidectomy in PHPT patients, the degree of recovery varies. Circulating microRNAs (miRNAs) profiles are known to be correlated with osteoporosis and fracture. We aimed to investigate whether osteoporotic fracture-related miRNAs are associated with postoperative BMD recovery in PHPT. Here, 16 previously identified osteoporotic fracture-related miRNAs were selected. We analyzed the association between the preoperative level of each miRNA and total hip (TH) BMD change. All 12 patients (among the 18 patients enrolled) were cured of PHPT after parathyroidectomy as parathyroid hormone (PTH) and calcium levels were restored to the normal range. Preoperative miR-19b-3p, miR-122-5p, and miR-375 showed a negative association with the percent changes in TH BMD from baseline. The association remained robust for miR-122-5p and miR-375 even after adjusting for sex, age, PTH, and procollagen type 1 N-terminal propeptide levels in a multivariable model. In conclusion, preoperative circulating miR-122-5p and miR-375 levels were negatively associated with TH BMD changes after parathyroidectomy in PHPT patients. miRNAs have the potential to serve as predictive biomarkers of treatment response in PHPT patients, which merits further investigation.
Highlights
Primary hyperparathyroidism (PHPT), a leading cause of secondary osteoporosis, is characterized by hypercalcemia and bone loss owing to the overproduction of parathyroid hormone (PTH) [1,2]
Lumachi et al suggested that premenopausal women had a greater lumbar spine (LS) bone mineral density (BMD) (L2-4) gain than postmenopausal women [40]
Alonso et al reported that PTH, CTx, and procollagen type 1 N-terminal propeptide (P1NP) levels were associated with changes in LS BMD in simple regression analysis in 53 PHPT patients [9]
Summary
Primary hyperparathyroidism (PHPT), a leading cause of secondary osteoporosis, is characterized by hypercalcemia and bone loss owing to the overproduction of parathyroid hormone (PTH) [1,2]. In patients with PHPT, the only curative treatment is surgery [3]. There is a large variance in bone mineral density (BMD) changes after parathyroidectomy among PHPT patients [5,6]. Sharma and colleagues demonstrated that BMD reduced after surgery in 31% of patients with PHPT [5]. PTH alone does not explain all changes in BMD after surgery [5,7]. Alkaline phosphatase (ALP), type 1 cross-linked C-terminal telopeptide collagen (CTx), and procollagen type 1 N-terminal propeptide (P1NP) have been suggested as predictors of BMD changes after surgery in PHPT patients, these observations remain controversial [6,8,9,10]
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