Impaired physical function and evaluation of quality of life in normocalcemic and hypercalcemic primary hyperparathyroidism

Voss, Lara; Nóbrega, Maira; Bandeira, Leonardo; Griz, Luiz; Rocha-Filho, Pedro Augusto Sampaio; Bandeira, Francisco

Affiliations

¹Division of Endocrinology & Diabetes, Agamenon Magalhaes Hospital, University of Pernambuco Medical School, Recife, Pernambuco, Brazil

²FBandeira Endocrine Institute, Recife, Pernambuco, Brazil

³Division of Neurology, Federal University of Pernambuco Medical School, Recife, Pernambuco, Brazil

Abstract and keywords

Introduction: Severe primary hyperparathyroidism may be associated with muscle weakness and fatigue, but little is known about this effect in milder forms of the disease. This study aimed to evaluate physical function and quality of life in patients with normocalcemic (NPHPT) and hypercalcemic (HPHPT) primary hyperparathyroidism.

Methods: This was a case-control study on 40 postmenopausal women. Thirteen patients with NPHPT, 7 patients with HPHPT, and their controls were studied. Mean serum PTH in the control group was 49.10 ± 12.38 pg/mL. All of the participants answered the Medical Outcomes Short-Form Health Survey (SF36) and were submitted to 2 strength tests (Hand Grip strength and Chair stand test) and 2 performance tests for physical function (Short physical performance battery and Gait speed). Body composition analysis was performed by dual-energy X-ray absorptiometry (DXA) and multifrequency bioimpedance (BIA).

Results: Patients with NPHPT had lower grip strength (p = 0.005), a higher mean time of the chair stand test (p = 0.012), a lower mean gait speed (p < 0.001) and a lower score for the Short Physical Performance Battery (SPPB) (p = 0.010) than the control group. Patients with HPHPT had lower handgrip strength (p = 0.027), a higher mean time of the chair stand test (p = 0.017), and a lower score for the SPPB (p = 0.049) than the control group. Patients with NPHPT showed a higher gait speed when compared to HPHPT (p = 0.048). There was no difference between BIA and DXA body composition indices between the PHPT groups and their controls. The evaluation of the SF-36 showed significantly less quality of life in the general health domain among the NPHPT group and in the mental health domain among the HPHPT than in the controls.

Conclusion: Patients with NPHPT and HPHPT have decreased physical performance and strength.

Keywords: Primary hyperparathyroidism; Muscle Strength; Parathyroid hormone; quality of life; Physical Functional Performance; Body Composition

Links

DOI: 10.1016/j.bone.2020.115583

PubMed: 32795678

WoS: 000602327700003

History

Received: 2020-04-13

Revised: 2020-08-7

Accepted: 2020-08-7

Online: 2020-08-11

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Cited By (2)

Year	Entry
2023	De Martino V, Pepe J, Biamonte F, Colangelo L, Di Giuseppe L, Nieddu L, Occhiuto M, Minisola S, Cipriani C. Impairment in muscle strength and its determinants in primary hyperparathyroidism: a study in postmenopausal women. Bone. January 2023;166:116604.
2022	Fuleihan GE-H, Chakhtoura M, Cipriani C, Eastell R, Karonova T, Liu J-M, Minisola S, Mithal A, Moreira CA, Peacock M, Schini M, Silva B, Walker M, El Zein O, Marcocci C. Classical and nonclassical manifestations of primary hyperparathyroidism. J Bone Miner Res. November 2022;37(11):2330-2350.