Bone status in patients with chronic hypoparathyroidism: results from the Italian HypoparaNET database

Background: Chronic hypoparathyroidism (HypoPT) is a rare endocrine condition, having variable etiology, characterized by low parathyroid hormone levels, leading to reduced calcium levels and increased phosphorus values in the blood. Bone health is an important clinical aspect to be considered in patients with HypoPT, whose skeleton is exposed both to the HypoPT-induced alteration of bone mass and microarchitecture, and to the natural occurrence and progression of bone mass loss due to menopause and ageing. Aim: Investigating bone status in a cohort of Italian HypoPT patients from the HypoparaNET database. Methods: In this cross-sectional study, we retrospectively analyzed bone status in 162 adult, and 11 children and adolescent HypoPT cases, based to their sex, age, HypoPT etiology, urinary excretion of calcium and phosphate, and serum level of 25(OH)-vitamin D. Results: Overall prevalence of osteoporosis in adult HypoPT patients was found to be slightly lower to that of the general population (17.3% vs 18.3%), increasing with ageing and being more frequent in postmenopausal women. Data from our HypoPT cohort confirmed that ageing and female sex are independent risk factors for osteoporosis, even among individuals with HypoPT. Discussion: Results from this study suggest the importance of a regular follow-up of bone health in HypoPT, especially in postmenopausal women and young patients with a genetic form of HypoPT. Conclusions: Medical therapies aim at restoring a balanced bone turnover and preventing bone tissue loss could be indicated in HypoPT cases with reduced bone mass to grant a better bone health at any age.