Advancements in Primary Hyperparathyroidism and Skeletal Health

Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by excessive or inappropriate secretion of parathyroid hormone (PTH), resulting in altered calcium and phosphate homeostasis. The skeleton is a major target of sustained PTH excess, with PHPT associated with increased bone turnover, reduced bone mineral density, impaired bone microarchitecture, osteoporosis, and increased fracture risk. Although earlier detection has led to a growing number of patients presenting with mild, asymptomatic, or normocalcemic disease, the extent and clinical significance of skeletal involvement across different PHPT phenotypes remain important areas of investigation. Advances in skeletal imaging, biomarkers, molecular and genetic research, and therapeutic approaches are also improving our ability to characterize, monitor, and manage bone health in these patients.This Research Topic aims to highlight recent advances in understanding the relationship between PHPT and skeletal health. We seek to explore the mechanisms underlying PTH-mediated skeletal alterations, including molecular and genetic determinants - even when a direct genotype–phenotype correlation is not shown, improve the identification and assessment of patients at risk of bone loss and fractures, and evaluate skeletal outcomes across different clinical presentations of PHPT. The collection will also examine how skeletal findings can inform clinical management and treatment decisions, and how surgical and medical interventions influence bone recovery and long-term skeletal health, with the goal of supporting improved risk stratification and personalized management of patients with PHPT.We welcome submissions addressing, but not limited to:• Mechanisms of skeletal involvement in PHPT, including PTH-mediated bone remodeling, bone turnover, and changes in bone quality• Molecular and genetic determinants of PHPT and skeletal involvement, including genetic variants and PTH action on bone• Familial and hereditary forms of PHPT, including syndromic and isolated forms• Bone mineral density and skeletal microarchitecture in PHPT, including advances in DXA-derived trabecular bone score and bone strain index together with other imaging approaches• Osteoporosis and fracture risk in PHPT, including risk factors, prediction, prevention, and clinical assessment• Skeletal manifestations across PHPT phenotypes, including classical, mild, asymptomatic, and normocalcemic disease• Clinical management and monitoring of skeletal health in PHPT, including treatment selection, indications for intervention, osteoporosis therapies, follow-up strategies, and personalized approaches based on skeletal risk• Skeletal outcomes following PHPT treatment, including parathyroidectomy, medical management, bone recovery, and long-term outcomes Topic editors: Laura Gianotti, Massimo Procopio Source: https://www.frontiersin.org/research-topics/85570/advancements-in-primary-hyperparathyroidism-and-skeletal-health