Interpretation of bone mass determinations as they relate to fracture: Implications for asymptomatic primary hyperparathyroidism

Munro Peacock

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Determination of bone mass is currently the most clinically useful measurement of bone strength and of fracture risk. Interpretation of bone mass determination as it relates to fracture has been developed largely from studies of age-related bone loss. A decrease in bone mass and an increase in fracture incidence with aging are universal phenomena that are causally related by virtue of the major contribution bone mass makes to skeletal strength. Over 70% of the skeleton's strength to resist fracture resides in its mineral content in vitro. Clinically, the relationship between trauma and fracture is complex, and in the general population, fracture appears as a random event occurring more frequently as bone mass decreases. In the individual, measurement of bone mass in relation to the range of bone mass and the fracture incidence of the reference population provides an estimate of the risk of sustaining a fracture in the future. In primary hyperparathyroidism, interpretation of a bone mass determination must take into account the effect of the disease activity on the skeleton against the background of universal age-related changes in bone mass and fracture incidence. This general relationship is likely to be altered by at least three unique effects that parathyroid hormone may have on the skeleton: (1) parathyroid hormone has a differential effect on cortical and cancellous bone; (2) it has a biphasic effect on bone that is concentration dependent; and (3) it alters bone quality and architecture. In asymptomatic patients with primary hyperparathyroidism who are considered for long-term medical follow-up, bone mass determination and fracture incidence must be part of the essential monitoring process both to provide a best estimate of fracture risk for the subject and to provide prospective data to refine the estimate of fracture risk for the disease itself.

Original languageEnglish
JournalJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
Volume6
Issue numberSUPPL. 2
StatePublished - Oct 1991

Fingerprint

Primary Hyperparathyroidism
Bone and Bones
Bone Fractures
Skeleton
Incidence
Parathyroid Hormone
Population
Osteoporosis
Minerals

ASJC Scopus subject areas

  • Surgery

Cite this

@article{b4eaa1af35dd44d7a613ec1342cff63d,
title = "Interpretation of bone mass determinations as they relate to fracture: Implications for asymptomatic primary hyperparathyroidism",
abstract = "Determination of bone mass is currently the most clinically useful measurement of bone strength and of fracture risk. Interpretation of bone mass determination as it relates to fracture has been developed largely from studies of age-related bone loss. A decrease in bone mass and an increase in fracture incidence with aging are universal phenomena that are causally related by virtue of the major contribution bone mass makes to skeletal strength. Over 70{\%} of the skeleton's strength to resist fracture resides in its mineral content in vitro. Clinically, the relationship between trauma and fracture is complex, and in the general population, fracture appears as a random event occurring more frequently as bone mass decreases. In the individual, measurement of bone mass in relation to the range of bone mass and the fracture incidence of the reference population provides an estimate of the risk of sustaining a fracture in the future. In primary hyperparathyroidism, interpretation of a bone mass determination must take into account the effect of the disease activity on the skeleton against the background of universal age-related changes in bone mass and fracture incidence. This general relationship is likely to be altered by at least three unique effects that parathyroid hormone may have on the skeleton: (1) parathyroid hormone has a differential effect on cortical and cancellous bone; (2) it has a biphasic effect on bone that is concentration dependent; and (3) it alters bone quality and architecture. In asymptomatic patients with primary hyperparathyroidism who are considered for long-term medical follow-up, bone mass determination and fracture incidence must be part of the essential monitoring process both to provide a best estimate of fracture risk for the subject and to provide prospective data to refine the estimate of fracture risk for the disease itself.",
author = "Munro Peacock",
year = "1991",
month = "10",
language = "English",
volume = "6",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley-Blackwell",
number = "SUPPL. 2",

}

TY - JOUR

T1 - Interpretation of bone mass determinations as they relate to fracture

T2 - Implications for asymptomatic primary hyperparathyroidism

AU - Peacock, Munro

PY - 1991/10

Y1 - 1991/10

N2 - Determination of bone mass is currently the most clinically useful measurement of bone strength and of fracture risk. Interpretation of bone mass determination as it relates to fracture has been developed largely from studies of age-related bone loss. A decrease in bone mass and an increase in fracture incidence with aging are universal phenomena that are causally related by virtue of the major contribution bone mass makes to skeletal strength. Over 70% of the skeleton's strength to resist fracture resides in its mineral content in vitro. Clinically, the relationship between trauma and fracture is complex, and in the general population, fracture appears as a random event occurring more frequently as bone mass decreases. In the individual, measurement of bone mass in relation to the range of bone mass and the fracture incidence of the reference population provides an estimate of the risk of sustaining a fracture in the future. In primary hyperparathyroidism, interpretation of a bone mass determination must take into account the effect of the disease activity on the skeleton against the background of universal age-related changes in bone mass and fracture incidence. This general relationship is likely to be altered by at least three unique effects that parathyroid hormone may have on the skeleton: (1) parathyroid hormone has a differential effect on cortical and cancellous bone; (2) it has a biphasic effect on bone that is concentration dependent; and (3) it alters bone quality and architecture. In asymptomatic patients with primary hyperparathyroidism who are considered for long-term medical follow-up, bone mass determination and fracture incidence must be part of the essential monitoring process both to provide a best estimate of fracture risk for the subject and to provide prospective data to refine the estimate of fracture risk for the disease itself.

AB - Determination of bone mass is currently the most clinically useful measurement of bone strength and of fracture risk. Interpretation of bone mass determination as it relates to fracture has been developed largely from studies of age-related bone loss. A decrease in bone mass and an increase in fracture incidence with aging are universal phenomena that are causally related by virtue of the major contribution bone mass makes to skeletal strength. Over 70% of the skeleton's strength to resist fracture resides in its mineral content in vitro. Clinically, the relationship between trauma and fracture is complex, and in the general population, fracture appears as a random event occurring more frequently as bone mass decreases. In the individual, measurement of bone mass in relation to the range of bone mass and the fracture incidence of the reference population provides an estimate of the risk of sustaining a fracture in the future. In primary hyperparathyroidism, interpretation of a bone mass determination must take into account the effect of the disease activity on the skeleton against the background of universal age-related changes in bone mass and fracture incidence. This general relationship is likely to be altered by at least three unique effects that parathyroid hormone may have on the skeleton: (1) parathyroid hormone has a differential effect on cortical and cancellous bone; (2) it has a biphasic effect on bone that is concentration dependent; and (3) it alters bone quality and architecture. In asymptomatic patients with primary hyperparathyroidism who are considered for long-term medical follow-up, bone mass determination and fracture incidence must be part of the essential monitoring process both to provide a best estimate of fracture risk for the subject and to provide prospective data to refine the estimate of fracture risk for the disease itself.

UR - http://www.scopus.com/inward/record.url?scp=0025872183&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025872183&partnerID=8YFLogxK

M3 - Article

C2 - 1763673

AN - SCOPUS:0025872183

VL - 6

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - SUPPL. 2

ER -