Hormonal Influences on Bone Remodeling and Bone Loss: Application to the Management of Primary Hyperparathyroidism
Authors: A. Michael Parfitt
Journal: Annals of Internal Medicine (1996)

Editorials1 September 1996Hormonal Influences on Bone Remodeling and Bone Loss: Application to the Management of Primary HyperparathyroidismA. Michael Parfitt, MDA. Michael Parfitt, MDUniversity of Arkansas for Medical Sciences, Little Rock, AR 72205Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-5-199609010-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The apparent prevalence and incidence of primary hyperparathyroidism increased about four-fold after routine multichannel biochemical screening began to be widely used [1]. This increase was sustained, and the average patient age at diagnosis also increased. This indicates that screening did not lead to diagnoses of hyperparathyroidism in the same patients at an earlier age (as occurred with screening for cervical cancer) but rather to the discovery of the condition in many persons who otherwise would have remained unburdened by knowledge of their condition [2]. Such persons—it begs several questions to call them patients, a role they did not seek—have, almost ...References1. Heath H 3d. Clinical spectrum of primary hyperparathyroidism: evolution with changes in medical practice and technology. J Bone Miner Res. 1991; 6:S63-70. Google Scholar2. Parfitt AM, Rao DS, Kleerekoper M. Asymptomatic primary hyperparathyroidism discovered by multi-channel biochemical screening: clinical course and considerations bearing on the need for surgical intervention. J Bone Miner Res. 1991; 6:S97-101. Google Scholar3. Kleerekoper M. Clinical course of primary hyperparathyroidism. In: Bilezikian JP, Marcus R, Levine M, eds. The Parathyroids: Basic and Clinical Concepts. New York: Raven; 1994:471-83. Google Scholar4. Lafferty FW, Hubay CA. Primary hyperparathyroidism. A review of the long-term surgical and nonsurgical morbidities as a basis for a rational approach to treatment. Arch Intern Med. 1986; 149:789-96. Google Scholar5. Silverberg SJ, Gartenberg F, Jacobs TP, Shane E, Siris E, Staron RB, et al. Increased bone mineral density after parathyroidectomy in primary hyperparathyroidism. J Clin Endocrinol Metab. 1995; 80:729-34. Google Scholar6. Johnston CC Jr, Melton LJ 3d, Lindsay R, Eddy DM. Clinical indications for bone mass measurements. J Bone Miner Res. 1989; 4(Suppl 2):1-28. Google Scholar7. Grey AB, Stapleton JP, Evans MC, Tatnell MA, Reid IR. Effect of hormone replacement therapy on bone mineral density in postmenopausal women with mild primary hyperparathyroidism. A randomized, controlled trial. Ann Intern Med. 1996; 125:360-8. Google Scholar8. Parfitt AM. 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Google Scholar13. Manolagas SC, Jilka RL, Bellido T, O'Brien CA, Parfitt AM. Interleukin 6 type cytokines and their receptors. In: Bilezikian JP, Raisz LG, Rodan GA, eds. Principles of Bone Biology. San Diego: Academic Pr. [In press]. Google Scholar14. Parisien M, Silverberg SJ, Shane E, de la Cruz L, Lindsay R, Bilezikian JP, et al. The histomorphometry of bone in primary hyperparathyroidism: preservation of cancellous bone structure. J Clin Endocrinol Metab. 1990; 70:930-8. Google Scholar15. Parfitt AM. Surface specific bone remodeling in health and disease. In: Kleerekoper M, Krane S, eds. Clinical Disorders of Bone and Mineral Metabolism. New York: Mary Ann Liebert; 1989:7-14. Google Scholar16. Bilezikian JP, Silverberg SJ, Shane E, Parisien M, Dempster DW. Characterization and evaluation of asymptomatic primary hyperparathyroidism. J Bone Miner Res. 1991; 6(Suppl 2):S85-9. Google Scholar17. Parfitt AM. Morphologic basis of bone mineral measurements. Transient and steady state effects of treatment in osteoporosis [Editorial]. Miner Electrolyte Metab. 1980; 4:273-87. Google Scholar18. Parfitt AM. Bone remodeling: relationship to the amount and structure of bone and the pathogenesis and prevention of fractures. In: Riggs BL, Melton LJ, eds. Osteoporosis: Etiology, Diagnosis, and Management. New York: Raven; 1988:45-94. Google Scholar19. Heaney RP. The bone-remodeling transient: implications for the interpretation of clinical studies of bone mass change. J Bone Miner Res. 1994; 9:1515-23. Google Scholar20. Grady D, Rubin SM, Pettiti DB, Fox CS, Black D, Ettinger B, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med. 1992; 117:1016-37. Google Scholar Author, Article, and Disclosure InformationAuthors: A. Michael Parfitt, MDAffiliations: University of Arkansas for Medical Sciences, Little Rock, AR 72205Corresponding Author: A. Michael Parfitt, MD, Endocrinology and Metabolism, University of Arkansas for the Medical Sciences Hospital, 4301 West Markham Street, Slot 587, Little Rock, AR 72205. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Hormone Replacement Therapy on Bone Mineral Density in Postmenopausal Women with Mild Primary Hyperparathyroidism Andrew B. Grey , Joanne P. Stapleton , Margaret C. Evans , Michele A. Tatnell , and Ian R. Reid Metrics Cited byGeneralized Uncoupled Bone Remodeling Associated With Delayed Healing of Fatigue FracturesParathyroid Hormone: A Uremic ToxinBone loss in chronic kidney disease: Quantity or quality?EphrinB2 signaling in osteoblasts promotes bone mineralization by preventing apoptosisEndocrine, Metabolic, and Nutritional DiseasesRapid cortical bone loss in patients with chronic kidney diseaseBone Mass and Microarchitecture in CKD Patients with FractureOsteocyte apoptosis and control of bone resorption following ovariectomy in miceChronic kidney disease and bone fracture: a growing concernCurrent Indications and Decision-making Leading to Parathyroidectomy: A Surgical ViewpointModeling and Remodeling: How Bone Cells Work Together Parts of this chapter have been previously published in Parfitt AM 1997 Genetic effects on bone mass and turnover-relevance to black/white differences. J Am Coll Nutr 16:325–333, and Parfitt AM 2004 New concepts of bone remodeling: A unified spatial and temporal model with physiological and pathophysiologic implications. In: Agarwal S, Stout S (eds) Kluwer Academic/Plenum New York (in press). Reproduced with permission of the publishers.Severe Cortical and Trabecular Osteopenia in Secondary HyperparathyroidismNew Concepts of Bone Remodeling: A Unified Spatial and Temporal Model with Physiologic and Pathophysiologic ImplicationsTargeted and nontargeted bone remodeling: relationship to basic multicellular unit origination and progressionPrimary Hyperparathyroidism of Postmenopausal WomenA Structural Approach to Renal Bone DiseaseEffects of Ethnicity and Age or Menopause on the Remodeling and Turnover of Iliac Bone: Implications for Mechanisms of Bone Loss 1 September 1996Volume 125, Issue 5Page: 413-415KeywordsBoneBone remodelingBone resorptionCalciumEstrogensHormone replacement therapyHyperparathyroidismOsteoclastsParathyroid hormoneSurgery ePublished: 15 August 2000 Issue Published: 1 September 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...