Factors associated with vertebral fracture risk in patients with primary hyperparathyroidism

Cristina Eller-Vainicher, Claudia Battista, Vito Guarnieri, Silvana Muscarella, Serena Palmieri, Antonio Stefano Salcuni, Giuseppe Guglielmi, Sabrina Corbetta, Salvatore Minisola, Anna Spada, Geoffrey N. Hendy, David E C Cole, Iacopo Chiodini, Alfredo Scillitani

Research output: Contribution to journalArticlepeer-review


Objective: To examine factors, in addition to bone mineral density (BMD), such as the common calcium-sensing receptor (CASR) gene polymorphisms, associated with vertebral fracture (VFx) risk in primary hyperparathyroidism (PHPT).

Design and methods: A cross-sectional analysis of 266 Caucasian PHPT seen as outpatients. Serum calcium (sCa) phosphate metabolism parameters were measured. BMD was assessed by dual-energy X-ray absorptiometry (expressed as Z-score) at lumbar spine (Z-LS) and femoral neck, morphometric VFx by radiograph, and CASR A986S/R990G genotypes by PCR amplification and genomic DNA sequencing.

Results: Fractured patients (n=100, 37.6%) had lower sCa (10.8±0.7mg/dl) and Z-LS BMD (-1.0±1.44), higher age (61±10 years), and prevalence (51%) of ≥1 S alleles of the CASR A986S single-nucleotide polymorphism (SNP; AS/SS), than those not fractured (nZ166, 11.2±1.0 mg/dl, -0.57±0.97, 58±13 years, and 38% AS/SS, respectively, P!0.05 for all comparisons). Logistic regression, with VFx as dependent variable, showed independent risks associated with increased age (OR 1.03, 95% CI 1.01-1.06, P=0.006), decreased sCa (OR 1.86, 95% CI 1.28-2.7, P=0.001), and Z-LS BMD (OR 1.4, 95% CI 1.12-1.7, P=0.002) and presence of AS/SS (OR 1.8, 95% CI 1.1-2.9, P=0.05). The presence of two out of three factors (age≥58 years, sCa

Conclusions: In PHPT, VFx is associated positively with age, negatively with sCa and spinal BMD, and presence of at least one copy of the CASR A986S SNP.

Original languageEnglish
Pages (from-to)399-406
Number of pages8
JournalEuropean Journal of Endocrinology
Issue number3
Publication statusPublished - Sep 1 2014

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

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