rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2021-97-102rsp-2996Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESКостные нарушения при синдроме множественных эндокринных неоплазий 1-го типа: обзор клинических данныхBone disorders in type 1 multiple endocrine neoplasia syndrome: A review of clinical datahttps://orcid.org/0000-0003-2669-9457ГорбачеваА. М.GorbachevaA. M.

Горбачева Анна Максимовна

117036, Москва, ул. Дм. Ульянова, 11

Gorbacheva Anna

117036, Moscow, Dm. Ulyanova str., 11

gorbacheva.anna@endocrincentr.ruhttps://orcid.org/0000-0001-6667-062XЕремкинаА. К.EremkinaA. K.

117036, Москва, ул. Дм. Ульянова, 11

Anna K. Eremkina

117036, Moscow, Dm. Ulyanova str., 11

 

https://orcid.org/0000-0002-9717-9742МокрышеваН. Г.MokryshevaN. G.

117036, Москва, ул. Дм. Ульянова, 11

Natalya G. Mokrysheva

117036, Moscow, Dm. Ulyanova str., 11

ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава РоссииРоссияThe National Medical Research Center for EndocrinologyRussian Federation20210303202159197102Copyright © Горбачева А.М., Еремкина А.К., Мокрышева Н.Г., 20212021Горбачева А.М., Еремкина А.К., Мокрышева Н.Г.Gorbacheva A.M., Eremkina A.K., Mokrysheva N.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2996

Первичный гиперпаратиреоз (ПГПТ) – заболевание, развивающееся вследствие опухолевого поражения околощитовидных желез и в основном проявляющееся повышением сывороточной концентрации паратиреоидного гормона (ПТГ) и гиперкальциемией. К числу наиболее частых осложнений ПГПТ относится патология костной ткани. В 5–10% случаев ПГПТ является не спорадическим заболеванием, а проявлением наследственной патологии, чаще – синдрома множественных эндокринных неоплазий 1-го типа (МЭН1). В основе данного синдрома лежит герминативная мутация в гене онкосупрессорного белка менина, определяемая во всех клетках организма человека, в том числе в клетках остеогенного ряда. Данные литературы, касающиеся состояния костной ткани при МЭН1, весьма ограничены и противоречивы. В то же время некоторые исследования свидетельствуют о наличии ряда особенностей течения костной патологии при ПГПТ, ассоциированном с МЭН1, что предположительно может быть связано с неполноценным функционированием мутантного менина. Результаты экспериментальных работ дают основания предполагать, что менин играет важную роль в метаболизме и дифференцировке клеток костной ткани. Данный обзор содержит информацию об имеющихся на сегодня клинических данных о состоянии костной ткани у пациентов с МЭН1.

Primary hyperparathyroidism (PHPT) is a result of the parathyroid tumors, usually manifesting by elevated serum parathyroid hormone and hypercalcemia. One of the most common complications of PHPT are bone disorders. It mainly occurs as sporadic disease, while the remaining 5–10% is the component of hereditary syndromes, more often – type 1 multiple endocrine neoplasia syndrome (MEN1). MEN1 is caused by the germinal mutation of the oncosuppressor menin gene, founded in all cells of the human body, including the osteogenic cells. Data on the bone state in MEN1 is limited and contradictory. At the same time, some studies indicate that MEN1-related PHPT differs from sporadic form in bone manifestation, which can be presumably associated with the inadequate functioning of mutant menin. The results of experimental works suggest that menin plays an important role in the metabolism and differentiation of bone cells. This article is a literature review on this problem and contains information on the current clinical data on the bone state in patients with MEN1.

синдром множественных эндокринных неоплазий 1-го типапервичный гиперпаратиреозостеопороззаболевания костной тканиmultiple endocrine neoplasia type 1primary hyperparathyroidismosteoporosisbone diseaseПубликация настоящей работы поддержана грантом РНФ № 20-75-00077 «Характеристика клеток остеогенного ряда в изогенной модельной системе при мутации в гене MEN1».ReferencesДедов ИИ, Мельниченко ГА, Мокрышева НГ, Рожинская ЛЯ, Кузнецов НС, Пигарова ЕА и др. Первичный гиперпаратиреоз: клиника, диагностика, дифференциальная диагностика, методы лечения. Проблемы эндокринологии. 2016;62(6):40–77. doi: 10.14341/probl201662640-77Dedov II, Melnichenko GA, Mokrysheva NG, Rozhinskaya LYa, Kuznetsov NS, Pigarova EA, et al. Primary hyperparathyroidism: The clinical picture, diagnostics, differential diagnostics, and methods of treatment. Problemy endokrinologii = Problems of Endocrinology. 2016;62(6):40−77 (In Russ.). doi: 10.14341/probl201662640-77Thakker RV, Newey PJ, Walls GV, Bilezikian J, Dralle H, Ebeling PR, et al. Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endocrinol Metab. 2012;97(9):2990−3011. doi: 10.1210/jc.2012-1230Thakker RV, Newey PJ, Walls GV, Bilezikian J, Dralle H, Ebeling PR, et al. Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endocrinol Metab. 2012;97(9):2990−3011. doi: 10.1210/jc.2012-1230Balsalobre Salmeron M, Rodriguez Gonzalez JM, Rios A, Febrero B, Paricio PP. Primary hyperparathyroidism associated with MEN1: Experience in 71 cases. Cir Esp. 2018;96(10):627−633. doi: 10.1016/j.ciresp.2018.06.014Balsalobre Salmeron M, Rodriguez Gonzalez JM, Rios A, Febrero B, Paricio PP. Primary hyperparathyroidism associated with MEN1: Experience in 71 cases. Cir Esp. 2018;96(10):627−633. doi: 10.1016/j.ciresp.2018.06.014Kaji H. Menin and bone metabolism. J Bone Miner Metab. 2012;30(4):381−387. doi: 10.1007/s00774-012-0355-3Kaji H. Menin and bone metabolism. J Bone Miner Metab. 2012;30(4):381−387. doi: 10.1007/s00774-012-0355-3Hendy GN, Kaji H, Canaff L. Cellular functions of menin. Adv Exp Med Biol. 2009;668:37−50. doi: 10.1007/978-1-4419-1664-8_4Hendy GN, Kaji H, Canaff L. Cellular functions of menin. Adv Exp Med Biol. 2009;668:37−50. doi: 10.1007/978-1-4419-1664-8_4Liu P, Lee S, Knoll J, Rauch A, Ostermay S, Luther J, et al. Loss of menin in osteoblast lineage affects osteocyte-osteoclast crosstalk causing osteoporosis. Cell Death Differ. 2017;24(4):672−682. doi: 10.1038/cdd.2016.165Liu P, Lee S, Knoll J, Rauch A, Ostermay S, Luther J, et al. Loss of menin in osteoblast lineage affects osteocyte-osteoclast crosstalk causing osteoporosis. Cell Death Differ. 2017;24(4):672−682. doi: 10.1038/cdd.2016.165Мокрышева НГ, Мирная СС, Добрева ЕА, Маганева ИС, Ковалева ЕВ, Крупинова ЮА и др. Первичный гиперпаратиреоз в России по данным Регистра. Проблемы эндокринологии. 2019;65(5):300–310. doi: 10.14341/probl10126Mokrysheva NG, Mirnaya SS, Dobreva EA, Maganeva IS, Kovaleva EV, Krupinova YuA, et al. Primary hyperparathyroidism in Russia according to the Registry. Problems of Endocrinology. 2019;65(5):300−310 (In Russ.). doi: 10.14341/probl10126Vestergaard P, Mollerup CL, Frøkjaer VG, Christiansen P, Blichert-Toft M, Mosekilde L. Cohort study of risk of fracture before and after surgery for primary hyperparathyroidism. BMJ. 2000;321(7261):598−602. doi: 10.1136/bmj.321.7261.598Vestergaard P, Mollerup CL, Frøkjaer VG, Christiansen P, Blichert-Toft M, Mosekilde L. Cohort study of risk of fracture before and after surgery for primary hyperparathyroidism. BMJ. 2000;321(7261):598−602. doi: 10.1136/bmj.321.7261.598Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018;14(2):115−125. doi: 10.1038/nrendo.2017.104Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018;14(2):115−125. doi: 10.1038/nrendo.2017.104De Geronimo S, Romagnoli E, Diacinti D, D’Erasmo E, Minisola S. The risk of fractures in postmenopausal women with primary hyperparathyroidism. Eur J Endocrinol. 2006;155(3):415−420. doi: 10.1530/eje.1.02225De Geronimo S, Romagnoli E, Diacinti D, D’Erasmo E, Minisola S. The risk of fractures in postmenopausal women with primary hyperparathyroidism. Eur J Endocrinol. 2006;155(3):415−420. doi: 10.1530/eje.1.02225Ejlsmark-Svensson H, Bislev LS, Lajlev S, Harsløf T, Rolighed L, Sikjaer T, et al. Prevalence and risk of vertebral fractures in primary hyperparathyroidism: A nested case-control study. J Bone Miner Res. 2018;33(9):1657−1664. doi: 10.1002/jbmr.3461Ejlsmark-Svensson H, Bislev LS, Lajlev S, Harsløf T, Rolighed L, Sikjaer T, et al. Prevalence and risk of vertebral fractures in primary hyperparathyroidism: A nested case-control study. J Bone Miner Res. 2018;33(9):1657−1664. doi: 10.1002/jbmr.3461Rejnmark L, Ejlsmark-Svensson H. Effects of PTH and PTH hypersecretion on bone: A clinical perspective. Curr Osteoporos Rep. 2020;18(3):103−114. doi: 10.1007/s11914-020-00574-7Rejnmark L, Ejlsmark-Svensson H. Effects of PTH and PTH hypersecretion on bone: A clinical perspective. Curr Osteoporos Rep. 2020;18(3):103−114. doi: 10.1007/s11914-020-00574-7Stein EM, Silva BC, Boutroy S, Zhou B, Wang J, Udesky J, et al. Primary hyperparathyroidism is associated with abnormal cortical and trabecular microstructure and reduced bone stiffness in postmenopausal women. J Bone Miner Res. 2013;28(5):1029−1040. doi: 10.1002/jbmr.1841Stein EM, Silva BC, Boutroy S, Zhou B, Wang J, Udesky J, et al. Primary hyperparathyroidism is associated with abnormal cortical and trabecular microstructure and reduced bone stiffness in postmenopausal women. J Bone Miner Res. 2013;28(5):1029−1040. doi: 10.1002/jbmr.1841Hansen S, Beck Jensen J-E, Rasmussen L, Hauge EM, Brixen K. Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyper-parathyroidism: A case-control study using HR-pQCT. J Bone Miner Res. 2010;25(9):1941−1947.Hansen S, Beck Jensen J-E, Rasmussen L, Hauge EM, Brixen K. Effects on bone geometry, density, and microarchitecture in the distal radius but not the tibia in women with primary hyper-parathyroidism: A case-control study using HR-pQCT. J Bone Miner Res. 2010;25(9):1941−1947.Hansen S, Hauge EM, Rasmussen L, Beck Jensen J-E, Brixen K. Parathyroidectomy improves bone geometry and microarchitecture in female patients with primary hyperparathyroidism: A one-year prospective controlled study using high-resolution peripheral quantitative computed tomography. J Bone Miner Res. 2012;27(5):1150−1158. doi: 10.1002/jbmr.1540Hansen S, Hauge EM, Rasmussen L, Beck Jensen J-E, Brixen K. Parathyroidectomy improves bone geometry and microarchitecture in female patients with primary hyperparathyroidism: A one-year prospective controlled study using high-resolution peripheral quantitative computed tomography. J Bone Miner Res. 2012;27(5):1150−1158. doi: 10.1002/jbmr.1540Liu M, Williams J, Kuo J, Lee JA, Silverberg SJ, Walker MD. Risk factors for vertebral fracture in primary hyperparathyroidism. Endocrine. 2019;66(3):682−690. doi: 10.1007/s12020-019-02099-1Liu M, Williams J, Kuo J, Lee JA, Silverberg SJ, Walker MD. Risk factors for vertebral fracture in primary hyperparathyroidism. Endocrine. 2019;66(3):682−690. doi: 10.1007/s12020-019-02099-1Grigorie D, Coles D, Sucaliuc A. Trabecular bone score (TBS) has a poor discriminative power for vertebral fractures in 153 Romani an patients with primary hyperparathyroidism. Acta Endocrinol (Bucharest, Rom 2005). 2018;14(2):208−212. doi: 10.4183/aeb.2018.208Grigorie D, Coles D, Sucaliuc A. Trabecular bone score (TBS) has a poor discriminative power for vertebral fractures in 153 Romani an patients with primary hyperparathyroidism. Acta Endocrinol (Bucharest, Rom 2005). 2018;14(2):208−212. doi: 10.4183/aeb.2018.208Leere JS, Kruse C, Robaczyk M, Karmisholt J, Vestergaard P. Associations between trabecular bone score and biochemistry in surgically vs conservatively treated outpatients with primary hyperparathyroidism: A retrospective cohort study. Bone Rep. 2018;9:101−109. doi: 10.1016/j.bonr.2018.08.001Leere JS, Kruse C, Robaczyk M, Karmisholt J, Vestergaard P. Associations between trabecular bone score and biochemistry in surgically vs conservatively treated outpatients with primary hyperparathyroidism: A retrospective cohort study. Bone Rep. 2018;9:101−109. doi: 10.1016/j.bonr.2018.08.001Rolighed L, Vestergaard P, Heickendorff L, Sikjaer T, Rejnmark L, Mosekilde L, et al. BMD improvements after operation for primary hyperparathyroidism. Langenbeck’s Arch Surg. 2013;398(1):113−120. doi: 10.1007/s00423-012-1026-5Rolighed L, Vestergaard P, Heickendorff L, Sikjaer T, Rejnmark L, Mosekilde L, et al. BMD improvements after operation for primary hyperparathyroidism. Langenbeck’s Arch Surg. 2013;398(1):113−120. doi: 10.1007/s00423-012-1026-5Sharma J, Itum DS, Moss L, Chun-Li C, Weber C. Predictors of bone mineral density improvement in patients undergoing parathyroidectomy for primary hyperparathyroidism. World J Surg. 2014;38(6):1268−1273. doi: 10.1007/s00268-014-2555-6Sharma J, Itum DS, Moss L, Chun-Li C, Weber C. Predictors of bone mineral density improvement in patients undergoing parathyroidectomy for primary hyperparathyroidism. World J Surg. 2014;38(6):1268−1273. doi: 10.1007/s00268-014-2555-6Nomura R, Sugimoto T, Tsukamoto T, Yamauchi M, Sowa H, Chen Q, et al. Marked and sustained increase in bone mineral density after parathyroidectomy in patients with primary hyper-parathyroidism: A six-year longitudinal study with or without parathyroidectomy in a Japanese population. Clin Endocrinol (Oxf). 2004;60(3):335−342. doi: 10.1111/j.1365-2265.2004.01984.xNomura R, Sugimoto T, Tsukamoto T, Yamauchi M, Sowa H, Chen Q, et al. Marked and sustained increase in bone mineral density after parathyroidectomy in patients with primary hyper-parathyroidism: A six-year longitudinal study with or without parathyroidectomy in a Japanese population. Clin Endocrinol (Oxf). 2004;60(3):335−342. doi: 10.1111/j.1365-2265.2004.01984.xLee D, Walker MD, Chen HY, Chabot JA, Lee JA, Kuo JH, et al. Bone mineral density changes after parathyroidectomy are dependent on biochemical profile. Surgery. 2019;165(1):107−113. doi: 10.1016/j.surg.2018.04.065Lee D, Walker MD, Chen HY, Chabot JA, Lee JA, Kuo JH, et al. Bone mineral density changes after parathyroidectomy are dependent on biochemical profile. Surgery. 2019;165(1):107−113. doi: 10.1016/j.surg.2018.04.065Lumachi F, Camozzi V, Ermani M, Lotto FDE, Luisetto G. Bone mineral density improvement after successful parathyroidectomy in pre- and postmenopausal women with primary hyperparathyroidism: A prospective study. Ann N Y Acad Sci. 2007;1117:357−361. doi: 10.1196/annals.1402.012Lumachi F, Camozzi V, Ermani M, Lotto FDE, Luisetto G. Bone mineral density improvement after successful parathyroidectomy in pre- and postmenopausal women with primary hyperparathyroidism: A prospective study. Ann N Y Acad Sci. 2007;1117:357−361. doi: 10.1196/annals.1402.012Koumakis E, Souberbielle J-C, Payet J, Sarfati E, Borderie D, Kahan A, et al. Individual site-specific bone mineral density gain in normocalcemic primary hyperparathyroidism. Osteoporos Int. 2014;25(7):1963−1968. doi: 10.1007/s00198-014-2689-2Koumakis E, Souberbielle J-C, Payet J, Sarfati E, Borderie D, Kahan A, et al. Individual site-specific bone mineral density gain in normocalcemic primary hyperparathyroidism. Osteoporos Int. 2014;25(7):1963−1968. doi: 10.1007/s00198-014-2689-2Мокрышева НГ. Околощитовидные железы. Первичный гиперпаратиреоз. М.: ООО «Медицинское информационное агенство»; 2019:448.Mokrysheva NG. Parathyroid glands. Primary hyperparathyroidism . Moscow: Ltd “Meditsinskoe informatsionnoe agenstvo”; 2019;448 (In Russ.).Zhang L, Liu X, Li H. Long-term skeletal outcomes of primary hyperparathyroidism patients after treatment with parathyroidec-tomy: A systematic review and meta-analysis. Horm Metab Res. 2018;50(3):242−249. doi: 10.1055/s-0043-125334Zhang L, Liu X, Li H. Long-term skeletal outcomes of primary hyperparathyroidism patients after treatment with parathyroidec-tomy: A systematic review and meta-analysis. Horm Metab Res. 2018;50(3):242−249. doi: 10.1055/s-0043-125334Lamas C, Navarro E, Casterás A, Portillo P, Alcázar V, Calatayud M, et al. MEN1-associated primary hyperparathyroidism in the Spanish registry: Clinical characteristics and surgical outcomes. Endocr Connect. 2019;8(10):1416−1424. doi: 10.1530/EC-19-0321Lamas C, Navarro E, Casterás A, Portillo P, Alcázar V, Calatayud M, et al. MEN1-associated primary hyperparathyroidism in the Spanish registry: Clinical characteristics and surgical outcomes. Endocr Connect. 2019;8(10):1416−1424. doi: 10.1530/EC-19-0321Lourenco DMJ, Toledo RA, Mackowiak II, Coutinho FL, Cavalcanti MG, Correia-Deur JEM, et al. Multiple endocrine neoplasia type 1 in Brazil: MEN1 founding mutation, clinical features, and bone mineral density profile. Eur J Endocrinol. 2008;159(3):259−274. doi: 10.1530/EJE-08-0153Lourenco DMJ, Toledo RA, Mackowiak II, Coutinho FL, Cavalcanti MG, Correia-Deur JEM, et al. Multiple endocrine neoplasia type 1 in Brazil: MEN1 founding mutation, clinical features, and bone mineral density profile. Eur J Endocrinol. 2008;159(3):259−274. doi: 10.1530/EJE-08-0153Sakurai A, Suzuki S, Kosugi S, Okamoto T, Uchino S, Miya A, et al. Multiple endocrine neoplasia type 1 in Japan: Establishment and analysis of a multicentre database. Clin Endocrinol (Oxf). 2012;76(4):533−539. doi: 10.1111/j.1365-2265.2011.04227.xSakurai A, Suzuki S, Kosugi S, Okamoto T, Uchino S, Miya A, et al. Multiple endocrine neoplasia type 1 in Japan: Establishment and analysis of a multicentre database. Clin Endocrinol (Oxf). 2012;76(4):533−539. doi: 10.1111/j.1365-2265.2011.04227.xKann PH, Bartsch D, Langer P, Hadji P, Pfützner A, Klüsener J. Peripheral bone mineral density in correlation to disease-related predisposing conditions in patients with multiple endocrine neoplasia type 1. J Endocrinol Invest. 2012;35(6):573−579. doi: 10.3275/7880Kann PH, Bartsch D, Langer P, Hadji P, Pfützner A, Klüsener J. Peripheral bone mineral density in correlation to disease-related predisposing conditions in patients with multiple endocrine neoplasia type 1. J Endocrinol Invest. 2012;35(6):573−579. doi: 10.3275/7880Norton JA, Venzon DJ, Berna MJ, Alexander HR, Fraker DL, Libutti SK, et al. Prospective study of surgery for primary hyperparathyroidism (HPT) in multiple endocrine neoplasia-type 1 and Zollinger-Ellison syndrome: Long-term outcome of a more virulent form of HPT. Ann Surg. 2008;247(3):501−510. doi: 10.1097/SLA.0b013e31815efda5Norton JA, Venzon DJ, Berna MJ, Alexander HR, Fraker DL, Libutti SK, et al. Prospective study of surgery for primary hyperparathyroidism (HPT) in multiple endocrine neoplasia-type 1 and Zollinger-Ellison syndrome: Long-term outcome of a more virulent form of HPT. Ann Surg. 2008;247(3):501−510. doi: 10.1097/SLA.0b013e31815efda5Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep. 2010;12(6):448−457. doi: 10.1007/s11894-010-0141-0Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep. 2010;12(6):448−457. doi: 10.1007/s11894-010-0141-0Цориев ТТ, Белая ЖЕ. Костно-суставные структурные нарушения при акромегалии. Проблемы эндокринологии. 2018;64(2):121−129. doi: 10.14341/probl9305Tsoriev TT, Belaya ZE. Bone and joint structural impairments in acromegaly. Problemy endokrinologii = Problems of Endocrinology. 2018;64(2):121−129 (In Russ.). doi: 10.14341/probl9305Паневин ТС, Алексеева ЛИ, Мельниченко ГА. Ревматические проявления акромегалии. Остеопороз и остеопатии. 2019;22(2):14−22. doi: 10.14341/osteo11353Panevin TS, Alekseeva LI, Melnichenko GA. Rheumatic manifestations of acromegaly. Osteoporosis and bone diseases. 2019;22(2):14−22 (In Russ.). doi: 10.14341/osteo11353Lourenço DMJ, Coutinho FL, Toledo RA, Montenegro FLM, Correia-Deur JEM, Toledo SPA. Early-onset, progressive, frequent, extensive, and severe bone mineral and renal complications in multiple endocrine neoplasia type 1-associated primary hyperparathyroidism. J Bone Miner Res. 2010;25(11):2382−2391. doi: 10.1002/jbmr.125Lourenço DMJ, Coutinho FL, Toledo RA, Montenegro FLM, Correia-Deur JEM, Toledo SPA. Early-onset, progressive, frequent, extensive, and severe bone mineral and renal complications in multiple endocrine neoplasia type 1-associated primary hyperparathyroidism. J Bone Miner Res. 2010;25(11):2382−2391. doi: 10.1002/jbmr.125Eller-Vainicher C, Chiodini I, Battista C, Viti R, Mascia ML, Massironi S, et al. Sporadic and MEN1-related primary hyperparathyroidism: Differences in clinical expression and severity. J Bone Miner Res. 2009;24(8):1404−1410. doi: 10.1359/jbmr.090304Eller-Vainicher C, Chiodini I, Battista C, Viti R, Mascia ML, Massironi S, et al. Sporadic and MEN1-related primary hyperparathyroidism: Differences in clinical expression and severity. J Bone Miner Res. 2009;24(8):1404−1410. doi: 10.1359/jbmr.090304Kong J, Wang O, Nie M, Shi J, Hu Y, Jiang Y, et al. Clinical and genetic analysis of multiple endocrine neoplasia type 1-related primary hyperparathyroidism in Chinese. PLoS One. 2016;11(11):e0166634. doi: 10.1371/journal.pone.0166634Kong J, Wang O, Nie M, Shi J, Hu Y, Jiang Y, et al. Clinical and genetic analysis of multiple endocrine neoplasia type 1-related primary hyperparathyroidism in Chinese. PLoS One. 2016;11(11):e0166634. doi: 10.1371/journal.pone.0166634Burgess JR, David R, Greenaway TM, Parameswaran V, Shepherd JJ. Osteoporosis in multiple endocrine neoplasia type 1: Severity, clinical significance, relationship to primary hyperparathyroidism, and response to parathyroidectomy. Arch Surg. 1999;134(10):1119−1123. doi: 10.1001/archsurg.134.10.1119Burgess JR, David R, Greenaway TM, Parameswaran V, Shepherd JJ. Osteoporosis in multiple endocrine neoplasia type 1: Severity, clinical significance, relationship to primary hyperparathyroidism, and response to parathyroidectomy. Arch Surg. 1999;134(10):1119−1123. doi: 10.1001/archsurg.134.10.1119Abdelhadi M, Nordenstrom J. Bone mineral recovery after parathyroidectomy in patients with primary and renal hyperparathyroidism. J Clin Endocrinol Metab. 1998;83(11):3845−3851. doi: 10.1210/jcem.83.11.5249Abdelhadi M, Nordenstrom J. Bone mineral recovery after parathyroidectomy in patients with primary and renal hyperparathyroidism. J Clin Endocrinol Metab. 1998;83(11):3845−3851. doi: 10.1210/jcem.83.11.5249Coutinho FL, Lourenço DMJ, Toledo RA, Montenegro FLM, Correia-Deur JEM, Toledo SPA. Bone mineral density analysis in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1 after total parathyroidectomy. Clin Endocrinol (Oxf). 2010;72(4):462−468. doi: 10.1111/j.1365-2265.2009.03672.xCoutinho FL, Lourenço DMJ, Toledo RA, Montenegro FLM, Correia-Deur JEM, Toledo SPA. Bone mineral density analysis in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1 after total parathyroidectomy. Clin Endocrinol (Oxf). 2010;72(4):462−468. doi: 10.1111/j.1365-2265.2009.03672.xSilva AM, Vodopivec D, Christakis I, Lyons G, Wei Q, Waguespack SG, et al. Operative intervention for primary hyperparathyroidism offers greater bone recovery in patients with sporadic disease than in those with multiple endocrine neoplasia type 1-related hyperparathyroidism. Surgery. 2017;161(1):107−115. doi: 10.1016/j.surg.2016.06.065Silva AM, Vodopivec D, Christakis I, Lyons G, Wei Q, Waguespack SG, et al. Operative intervention for primary hyperparathyroidism offers greater bone recovery in patients with sporadic disease than in those with multiple endocrine neoplasia type 1-related hyperparathyroidism. Surgery. 2017;161(1):107−115. doi: 10.1016/j.surg.2016.06.065Yeh MW, Ituarte PHG, Zhou HC, Nishimoto S, Liu ILA, Harari A, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122−1129. doi: 10.1210/jc.2012-4022Yeh MW, Ituarte PHG, Zhou HC, Nishimoto S, Liu ILA, Harari A, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122−1129. doi: 10.1210/jc.2012-4022Wermers RA, Khosla S, Atkinson EJ, Achenbach SJ, Oberg AL, Grant CS, et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993–2001: An update on the changing epidemiology of the disease. J Bone Miner Res. 2006;21(1):171–177. doi: 10.1359/JBMR.050910Wermers RA, Khosla S, Atkinson EJ, Achenbach SJ, Oberg AL, Grant CS, et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993–2001: An update on the changing epidemiology of the disease. J Bone Miner Res. 2006;21(1):171–177. doi: 10.1359/JBMR.050910Giusti F, Tonelli F, Brandi ML. Primary hyperparathyroidism in multiple endocrine neoplasia type 1: When to perform surgery? Clinics (Sao Paulo). 2012;67Suppl 1:141−144. doi: 10.6061/clinics/2012(sup01)23Giusti F, Tonelli F, Brandi ML. Primary hyperparathyroidism in multiple endocrine neoplasia type 1: When to perform surgery? Clinics (Sao Paulo). 2012;67Suppl 1:141−144. doi: 10.6061/clinics/2012(sup01)23Tonelli F, Marini F, Giusti F, Brandi ML. Total and subtotal parathyroidectomy in young patients with multiple endocrine neoplasia type 1-related primary hyperparathyroidism: Potential post-surgical benefits and complications. Front Endocrinol (Lausanne). 2018;9:558. doi: 10.3389/fendo.2018.00558Tonelli F, Marini F, Giusti F, Brandi ML. Total and subtotal parathyroidectomy in young patients with multiple endocrine neoplasia type 1-related primary hyperparathyroidism: Potential post-surgical benefits and complications. Front Endocrinol (Lausanne). 2018;9:558. doi: 10.3389/fendo.2018.00558

The authors declare that there are no conflicts of interest present.