This study investigated the effect of long-term treatment upon bone density with L-Thyroxine in postmenopausal women compared with untreated postmenopausal women with climacteric symptoms. We measured spinal bone density in three groups (n = 84) of postmenopausal women: (A) those treated with TSH-suppressive doses of L-Thyroxine for a medium of 5 years after removal of thyroid cancer; (B) those on L-Thyroxine treatment for a median of 9 years after being diagnosed with chronic lymphocytic thyroiditis (CLT); and (C) those with no thyroid disease or other known pathology and without any treatment. There were no differences in dietary calcium intake and daily activity between untreated and L-Thyroxine-treated women. Measurements of bone mineral density were performed at spine level L1-L4 using a dual X-ray densitometer and serum thyroid-stimulating hormone (TSH), thyroid hormones, and bone markers (serum osteocalcin, procollagen I, urinary calcium), and PTH levels were assayed and found to be within normal ranges. Women receiving L-Thyroxine after thyroid cancer had slightly higher FT4 levels compared with women who had CLT and lower TSH levels, with serum T4 and T3 levels normal and similar in both groups. No significant differences were found in spinal bone density after L-Thyroxine treatment between Groups A and B and compared with Group C. Bone loss according to 2 SD below reference standards (age and sex matched) was found in the 12.9% of L-Thyroxine-treated patients versus 22.6% of untreated women. No correlation was found between bone loss and thyroid hormone levels and duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
To clarify the relationship of sex male hormones and bone in men, we studied in 140 healthy elderly men (aged 55-90 years) the relation between serum levels of androgens and related sex hormones, bone mineral density (BMD) at different sites, and other parameters related to bone metabolism. Our results show a slight decrease of serum-free testosterone with age, with an increase of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in a third of the elderly subjects studied. BMD decreased significantly with age in all regions studied, except in the lumbar spine. We found a positive correlation between body mass index (BMI) and BMD at the lumbar spine and femoral neck (P < 0.001). No relationship was found (uni- and multivariate regression analysis) between serum androgens or sex hormone-binding globulin (SHBG) and BMD. We found a positive correlation of vitamin D binding protein (DBP) and osteocalcin with lumbar spine BMD and with BMI, DBP, IGF-1, and PTH with femoral neck BMD. In conclusion, there is a slight decline in free testosterone and BMD in the healthy elderly males. However, sex male hormones are not correlated to the decrease in hip BMD. Other age-related factors must be associated with bone loss in elderly males.
Recent studies have shown growth-related changes in spinal bone mineral density (BMD) in children; however, there is less information available on the relationship between BMD and insulin-like growth factor I (IGF-I). The aim of this study was to relate the BMD of the spine and radius with serum IGF-I levels and auxological variables in normally growing children. We used dual X-ray absorptiometry to measure the BMD in the lumbar spine (L1-L4) and distal radius of 121 children (69 boys, 52 girls) aged 3-18 years whose growth velocity was normal. Lumbar and radial BMD increased with age (p< 0.001) and puberty (p < 0.001) and was highly correlated to age, weight, height, body surface and bone age (r = 0.70-0.89 and p < 0.001 for all variables). Partial correlation, with age held constant, was weaker but still significant for most auxological variables. Serum IGF-I concentrations increased slowly during childhood and markedly during early stages of puberty, and correlated with lumbar and radial BMD (r = 0.55 and 0.45, respectively; p < 0.001) and with the auxological variables (p < 0.001). When age was held constant, IGF-I levels still correlated significantly with the auxological variables and with BMD, except in the case of radial BMD in boys. By multiple regression analysis IGF-I, unlike auxological variables, did not reach significance in the ability to predict BMD. Therefore, in healthy children, serum IGF-I levels show a weaker relationship to BMD than do auxological variables.
Several studies have analyzed the correlation between axial bone mineral density (BMD) measured by dual X-ray absorptiometry (DXA) and growth parameters. However, little is known about the growth-related changes in appendicular BMD measured by this technique. We used DXA to measure BMD in the lumbar spine (L1-L4) and distal radius in 121 normal growing children (69 boys, 52 girls), aged 3 to 18 yr. Both lumbar and radius BMD showed a steady increase with age and a steeper increment during puberty. There was a good correlation between spinal and radial BMD (r = 0.83; p < 0.001) and both were highly correlated with growth parameters; their respective correlation coefficients did not differ significantly for chronological age (r = 0.70 vs 0.80), weight (r = 0.77 vs 0.76), height (r = 0.73 vs 0.79), body surface (r = 0.78 vs 0.80), body mass index (r = 0.54 vs 0.49) and bone age (r = 0.77 vs 0.79). By multiple regression analysis the best predictors for spinal BMD were bone age, pubertal stage and weight, while for radial BMD the best predictors were chronological age and weight. We have shown that the measurement of BMD by DXA at distal radius, an easily accessible bone, has a correlation with growth parameters as good as lumbar spine BMD measurements in children.
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