Densidade mineral óssea de crianças e adolescentes com hipotireoidismo congênito

Demartini, Adriane de A.C.; Kulak, Carolina A. M.; Borba, Victoria; Cat, Mônica Nunes Lima; Dondoni, Roberta Savaris; Sandrini, Romolo; Nesi-França, Suzana; Filho, Luiz de Lacerda

doi:10.1590/s0004-27302007000700010

Cited by 10 publications

(7 citation statements)

References 34 publications

(37 reference statements)

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“…However, it has been shown in children with congenital hypothyroidism that bone density is lower than normal children. [ 39 ] In children with subclinical hypothyroidism, bone qualities by using of quantitative ultrasound were studied. The results showed that with increasing concentrations of TSH, calculated osteo sono-assessment index is reduced.…”

Section: Discussionmentioning

confidence: 99%

Effects of Levothyroxine and thyroid stimulating hormone on bone loss in patients with primary hypothyroidism

Karimifar¹,

Esmaili²,

Salari³

et al. 2014

J Res Pharm Pract

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Objective:Previous studies on bone mineral density (BMD) abnormalities associated with hypothyroidism are scarce and not conclusive. The effect of thyroid hormone therapy on BMD has shown mixed results. The aim of the present study was to determine the severities of osteoporosis in female patients with hypothyroidism in comparison to healthy women.Methods:This cross-sectional descriptive study was performed on 150 women aged over 50 years. Totally, 100 patients with primary hypothyroidism and 50 healthy subjects were enrolled in this study and divided into three groups. Group A, which consisted the patients who had been recently diagnosed with primary hypothyroidism. The second group of patients diagnosed with primary hypothyroidism for at least 2 years and was treated with levothyroxine (Group B). The third group of healthy individuals was selected as a control group (Group C). Blood samples were taken for the measurements of thyroid stimulating hormone (TSH), and bone densitometry was performed to determine the BMD reported as T-score in order to measure the severity of osteoporosis. T-score of the lumbar vertebra (L2-L4) and femoral neck were measured with dual energy X-ray absorptiometry and were compared between the three groups. Data were analyzed by SPSS using regression analysis and Mann–Whitney, Kruskal–Wallis, or analysis of variances statistical tests. The statistical significance was set at a P < 0.05.Findings:The average age of patients and baseline serum TSH levels in Group B was significantly different from the other two groups (P < 0.001). T-score of the lumbar spine (L2-L4) in Group B was significantly lower than the other groups (P = 0.01). The linear regression between serum TSH levels and BMD categories were not clearly associated. However, after removing the effect of the baseline TSH level in Group B, bone loss was significantly greater than the other two groups (P = 0.01).Conclusion:According to the present study, it seems that the treatment of hypothyroidism with thyroid hormones reduces both serum levels of TSH and bone density. Hence, proper control of this risk factor can be an effective way in prevention of osteoporosis.

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Section: Discussionmentioning

confidence: 99%

Effects of Levothyroxine and thyroid stimulating hormone on bone loss in patients with primary hypothyroidism

Karimifar¹,

Esmaili²,

Salari³

et al. 2014

J Res Pharm Pract

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“…[33] However, in children with congenital hypothyroidism, BMD was lower than in the normal children. [34] Bone quality was studied by Nagata et al . using quantitative ultrasound (QUS) in subjects with subclinical hypothyroidism.…”

Section: Hypothyroidism and Bonementioning

confidence: 99%

Thyroid disorders and bone mineral metabolism

Dhanwal

2011

Indian J Endocr Metab

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Thyroid diseases have widespread systemic manifestations including their effect on bone metabolism. On one hand, the effects of thyrotoxicosis including subclinical disease have received wide attention from researchers over the last century as it an important cause of secondary osteoporosis. On the other hand, hypothyroidism has received lesser attention as its effect on bone mineral metabolism is minimal. Therefore, this review will primarily focus on thyrotoxicosis and its impact on bone mineral metabolism.

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“…However, no impairment in bone health evaluated by DXA and QUS was observed in congenital hypothyroid children and adolescents after long-term L-thyroxine replacement therapy [31,32]. Conversely, in another study BMD was normal in treated children with congenital hypothyroidism but slightly lower than healthy controls [33]. In our SH children height was normal, within the target height, and skeletal maturation was adequate to the chronological age.…”

Section: Discussionmentioning

confidence: 64%

Bone health in children with long–term idiopathic subclinical hypothyroidism

et al. 2012

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BackgroundSubclinical hypothyroidism (SH) is a relatively common condition characterized by a mild persistent thyroid failure. The management of children with SH is still a controversial issue and the decision to treat with L-thyroxine represents a clinical dilemma. Thyroid hormone and TSH play an important role in skeletal growth and bone mineral homeostasis.AimTo evaluate whether untreated idiopathic SH may affect bone health in childhood and to compare two different diagnostic tools such as dual-energy X-ray densitometry (DXA) and quantitative ultrasound (QUS).Patients and MethodsTwenty-five children and adolescents (11 males) aged 9.8 ± 3.5 years (range 4.2-18.7) with untreated idiopathic SH were enrolled in the study. SH was diagnosed on the basis of normal FT4 levels with TSH concentrations between 4.2 and 10 mU/l. Children have been followed for 3.3 ± 0.3 years from the time of SH diagnosis. Twenty-five healthy children, age- and sex-matched, were enrolled as controls. Patients and controls underwent DXA to evaluate lumbar spine bone mineral density (BMD) and QUS at proximal phalanges of the non-dominant hand to assess bone quality, measured as amplitude-dependent speed of sound (Ad-SoS) and bone transmission time (BTT).ResultsMean BMD Z-score was −0.4 ± 1.36 in patients and −0.2 ± 1.2 in controls. Mean Ad-SoS Z-score was 0.01 ± 1.0 in patients and 0.1 ± 1.2 in controls and mean BTT Z-score was −0.03 ± 0.8 and 0.04 ± 1.1 respectively. All values were within the normal range, both in patients and in controls. There were no statistically significant differences between the two groups.ConclusionBone health, evaluated by lumbar spine DXA and phalangeal QUS, is not impaired in our children, despite long-term duration of idiopathic SH. Data about bone status provided by QUS are comparable to those provided by DXA. Therefore, QUS may represent a good, cheaper and safe screening test for bone evaluation in children with SH.

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Densidade mineral óssea de crianças e adolescentes com hipotireoidismo congênito

Cited by 10 publications

References 34 publications

Effects of Levothyroxine and thyroid stimulating hormone on bone loss in patients with primary hypothyroidism

Effects of Levothyroxine and thyroid stimulating hormone on bone loss in patients with primary hypothyroidism

Thyroid disorders and bone mineral metabolism

Bone health in children with long–term idiopathic subclinical hypothyroidism

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