Dynamic and structural properties of the skeleton in hypoparathyroidism

Rubin MR, Dempster DW, Zhou H, Shane E, Nickolas T, Sliney J, Silverberg SJ, Bilezikian JP

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2008

Abstract

Hypoparathyroidism, a disorder in which PTH is absent, is associated with BMD that is above average. We studied associated structural and dynamic properties of the skeleton in hypoparathyroidism. Thirty-three subjects with hypoparathyroidism and 33 age- and sex-matched control subjects with no known metabolic diseases underwent percutaneous iliac crest bone biopsies after double-labeling with tetracycline. The main outcome was histomorphometric assessment of structural and dynamic skeletal parameters. Subjects with hypoparathyroidism had greater cancellous bone volume (mean +/- SD; BV/TV: 23.5 +/- 8 versus 19.7 +/- 5%, p = 0.02), trabecular width (Tb.Wi: 136.1 +/- 37 versus 119.3 +/- 21 microm, p = 0.03), and cortical width (Ct.Wi: 923.4 +/- 420 versus 753.5 +/- 246 microm, p = 0.05) than control subjects. Dynamic skeletal indices, including mineralizing surface (MS: 0.85 +/- 1.58 versus 4.27 +/- 3.32%, p < 0.0001) and bone formation rate (BFR/BS: 0.006 +/- 0.014 versus 0.032 +/- 0.028 microm(3)/microm(2)/d, p < 0.0001), were profoundly suppressed in the hypoparathyroid subjects. We conclude that hypoparathyroidism is characterized by markedly unusual structural and dynamic properties of bone.

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