Hilmi Erdem SÜMBÜL, Begüm Şeyda AVCI, Mehmet Akif ERDÖL

N-Terminal-pro-Brain Natriuretic Peptide Is Increased and Closely Related with Osteoporosis in Patients with Newly Diagnosed Primary Hyperparathyroidism

Objective: The aim of this study is to determine the prevalence of osteopenia and osteoporosis in newly diagnosed primary hyperparathyroidism patients and to evaluate the relationship between the presence of osteoporosis and the primary hyperparathyroidism routine laboratory parameters including N-terminal-pro-brain natriuretic peptide. Methods: This prospective study included 94 patients (mean age: 59.7 ± 11.7 years, female/male: 78/16) who have been diagnosed with primary hyperparathyroidism. For all patients participating in this study, laboratory tests were performed (routine tests and tests for diagnosing hyperparathyroidism), and dual-energy x-ray absorptiometry inspections were also performed. The participants of the study were divided into 3 groups according to T score in dual-energy X-ray absorptiometry as normal (group I or T score >−1), patients with osteopenia (group II or T score between −1 and −2.5), and the patients with osteoporosis (group III or T score ≤ −2.5). Results: Notable level increase of blood urea nitrogen and N-terminal-pro-brain natriuretic peptide from group I to group III is seen in the results. In logistic regression analysis, it was found that levels of N-terminal-pro-brain natriuretic peptide and urine calcium independently determined the patients for osteoporosis (P < .05). According to the analysis, it was found that increasing levels of urine calcium (per 10 mg/day) and N-terminal-pro-brain natriuretic peptide (per 10 pg/mL) increase the risk of osteoporosis by 8.6% and 9.1% for patients, respectively. When we took N-terminal-pro-brain natriuretic peptide and urine calcium cut-off values as 200 pg/mL and 300 mg/day, respectively, it determines patients for osteoporosis with 82.6% sensitivity and 73.2% specificity, and 73.9% sensitivity and 63.4% specificity, respectively. N-terminalpro-brain natriuretic peptide and urinary calcium levels were independently associated with T score in dual-energy X-ray absorptiometry. Conclusion: The primary outcome of this study is N-terminal-pro-brain natriuretic peptide levels are significantly increased in newly diagnosed primary hyperparathyroidism patients and are independently associated with osteoporosis presence. In addition, apart from N-terminal-pro-brain natriuretic peptide level, urine calcium level is also independently associated with osteoporosis presence, in our study.

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