ECTS2013 Poster Presentations Muscle, physical activity and bone (26 abstracts)
Muscle function and quality of life in primary hyperparathyroidism
Lars Rolighed 1 , Anne Kristine Amstrup 2 , Niels Frederik Breum Jakobsen 2 , Tanja Sikjaer 2 , Leif Mosekilde 2 , Peer Christiansen 1 & Lars Rejnmark 2
1Department of Surgery P, Aarhus, Denmark; 2Department of Endocrinology and Metabolism MEA, Aarhus, Denmark.
Introduction: In spite of the frequent encounter of ‘asymptomatic’ primary hyperparathyroidism (PHPT), the patients often describe various relevant improvements postoperatively suggesting a subclinical biological effect of elevated PTH or hypercalcaemia.
Materials and methods: To evaluate muscle function, postural stability, and quality of life (QoL) in untreated PHPT, we assessed maximal isometric muscle strength in upper and lower extremities, time of ten repeated-chair-stands (RCS), time to walk 3 m and back (TTW), balance function, and questionnaires of QoL in 58 untreated PHPT patients and 58 controls matched on age, sex, and menopausal status.
Results: Patients and controls had a mean age of 59 years and 47 (81%) were women. We found marked differences between groups in PTH (13.9 vs 4.8 pmol/l) and ionized calcium levels (1.45 vs 1.24 mmol/l), whereas plasma creatinine and 25(OH)D levels did not differ. In PHPT, the SF-36 questionnaire showed a lower QoL in all eight domains (P<0.05) and the WHO-5 index showed a reduced well-being (P<0.001). Postural stability was impaired in PHPT during normal standing with eyes open (P<0.05) and eyes closed (P<0.001). Female patients spent significantly longer time on performing the RCS- and TTW-tests, and had a lower muscle strength in upper (P<0.01) and lower extremities (P<0.001) compared with female controls. In men, muscle function and strength did not differ between groups.
Conclusions: In PHPT, constantly elevated PTH and calcium levels seem to have deleterious effects on muscle strength, muscle function, postural stability and QoL. The increased risk of fracture in PHPT may therefore both be related to a decreased BMD and a reduced postural stability and muscle strength.
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