The significantly higher rate of new fractures in correlation with low levels of parathyroid hormone in our study goes in line with the pathophysiologic effect of lower bone remodelling and lower bone quality in hypoparathyroidism, although the effect was small in our cohort with an odds ratio of 0.984 (95% CI 0.966–1.000; p = 0.047). Here, PTH is linked to hypoparathyroidism.