Partial primary osteoporosis maybe due to parathyroid hyperfunction caused by calcium intake insufficiency and/or vitamin D insufficiency/deficiency

Abstract

Osteoporosis is a global public health problem, characterized by severe morbidity and mortality of osteoporotic fractures. Meanwhile, there is a significant global prevalence of calcium intake insufficiency and/or vitamin D insufficiency/deficiency (CVI). Long-term of CVI may result in a negative calcium balance, leading to parathyroid hyperplasia, hypertrophy and hyperfunction, causing increased secretion of parathyroid hormone (PTH) which is still within the normal range. This condition is called parathyroid hyperfunction. Parathyroid hyperfunction plays a crucial role in maintaining calcium homeostasis by increasing bone resorption and raising serum calcium levels, which is a rapid and sustained process. Osteoporosis resulting from parathyroid hyperfunction is often diagnosed as primary osteoporosis because it does not meet the criteria for hyperparathyroidism. Therefore, partial primary osteoporosis is not truly primary but rather secondary osteoporosis due to parathyroid hyperfunction caused by CVI. Early recognition and intervention for this secondary osteoporosis can effectively prevent issues such as decreased height, humpback, pain, fatigue, fracture, nephrolithiasis, metastatic vascular calcification, and abnormal calcium migration and precipitation of the whole body.