Objective:Primary Hyperparathyroidism (PHPT) is a common disease, frequently
diagnosed in post-menopausal women, among whom Osteoporosis (OP) is a common finding.
To date, no study has specifically evaluated the asymptomatic PHPT (aPHPT) patients without
OP, in particular post-menopausal women who are exposed to an increased risk of developing
OP.Materials and Methods:This study involved a retrospective cross-sectional evaluation. From
our database of 500 consecutive patients diagnosed with PHPT, 178 post-menopausal aPHPT
were retrieved.Results:The clinical, biochemical, and imaging data of the 85 patients without OP were not
different from those of the 93 with OP, except for bone alkaline phosphatase (significantly
higher in the latter group). Among these 85 patients without OP, the 45 patients meeting surgical
criteria for parathyroidectomy had significantly higher values of serum PTH (240 vs. 99
ng/L, p =0.03) and calcium (total, 11.2 ± 0.7 vs. 10.6 ± 0.4 mg/dL, p <0.001; ionized, 1.45 ±
0.12 vs. 1.36 ± 0.8 mmol/L, p =0.044) and lower values of serum phosphate (2.57 ± 0.7 vs. 2.94
± 0.5 mg/dL, p =0.009) and eGFR (68.5 ± 23.8 vs 80.8 ± 14.4 mL/min/1.73 m2, p =0.006) than
the 40 aPHPT patients not meeting surgical criteria, without any difference in densitometric
data and calculated fracture risk.Conclusion:In our series, post-menopausal aPHPT patients without OP accounted for almost a
sixth of the whole PHPT series. About half of these patients did not meet surgical criteria, but
their T scores and 10-year fracture risk calculated by FRAX were not significantly different
from post-menopausal aPHPT without OP meeting surgical criteria.