A cross-sectional study to examine the correlation between serum TSH levels and the osteoporosis of the lumbar spine in healthy women with normal thyroid function

Noh, Hye-Mi; Park, Y. S.; Lee, J.; Lee, W.

doi:10.1007/s00198-014-2906-z

Cited by 35 publications

(22 citation statements)

References 29 publications

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“…Several other studies have evaluated adult euthyroid individuals with respect to thyroid hormones and their interaction with bone mass behavior. However, due to the different designs and characteristics of the populations studied, there is currently no consensus on whether a variation in serum concentration of thyroid hormones within the euthyroid serum range affects bone metabolism and consequently bone mineral density (BMD) and fracture risk (3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Lack of Influence of Thyroid Hormone on Bone Mineral Density and Body Composition in Healthy Euthyroid Women

Zantut-Wittmann¹,

Quintino‐Moro

Santos

et al. 2020

Front. Endocrinol.

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The objective of this study was to evaluate whether evolution of bone mineral density (BMD) is associated with the thyroid hormone profile in a cohort of euthyroid women with no other known diseases within 1 year. Methods: This was a prospective cohort study conducted at the University of Campinas, Brazil. We used a database with 52 women aged 20-39 who were followed for 1 year in a family planning outpatient clinic. The inclusion criteria were body mass index (BMI) <30 kg/m 2 , no known diseases/medication use, fasting glucose <100 mg/dl, and 2 h glucose after a 75 g oral glucose load <140 mg/dl. The women were divided into groups of normal weight (n = 30) and overweight (n = 22). The main outcomes were BMD measured by dual-energy x-ray absorptiometry (DXA) and thyroid hormone profile (thyrotropin TSH, free triiodothyronine FT3, free thyroxine FT4, and T3/T4 ratio); other variables were body composition (DXA), calcium metabolism markers, and life habits. We used a repeated measures analysis of variance (ANOVA) and multiple regression analyses to evaluate associations. Results: At the baseline data collection, overweight women showed a higher T3/T4 ratio, leptin, calcium, BMD in the lumbar spine and total femur, total mass, mass, and percentage of fat mass than normal weight women. At 12 months, both groups had increased FT4, calcium, ALP, femoral neck BMD, and total mass by time effect. The normal weight group presented a decrease of vitamin D when compared to the baseline. Increased BMD of the femoral neck was associated with moderate coffee intake, and as such, there were no associations found between this increase and the thyroid hormone profile. Leptin and ALP were associated with total mass variation, while leptin and PTH were associated with fat mass variation. The normal BMI was inversely associated with the variation of total mass, mass, and percentage of fat mass, and engaging in regular physical activity was inversely associated with fat mass variation. Conclusions: In this sample of euthyroid healthy women who were both normal weight and overweight, the thyroid hormone profile was not associated with variations in bone mineral density and body composition after a 1 year follow-up.

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Section: Introductionmentioning

confidence: 99%

Lack of Influence of Thyroid Hormone on Bone Mineral Density and Body Composition in Healthy Euthyroid Women

Zantut-Wittmann¹,

Quintino‐Moro

Santos

et al. 2020

Front. Endocrinol.

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“…Based on recent studies, low levels of TSH increase the risk for low BMD and fractures, particularly in postmenopausal women, but since prospective studies on fracture risk in young women and men are scarce, the risk of TSH-suppressive therapy is difficult to assess properly [2, 3, 14, 16]. Our patient suffered significantly from her hyperthyroid bone condition, but on the other hand, she had used a higher levothyroxine dose than normally prescribed in TSH-suppressive therapy (5.0 vs 2–3 μg/kg/day) [6].…”

Section: Discussionmentioning

confidence: 99%

“…Also, subclinical hyperthyroidism, and even serum thyrotropin (S-TSH) levels within the low-normal range in euthyroid elderly women, has been shown to increase the risk of low bone mineral density (BMD) and fractures [1–3]. When examining patients with long-term levothyroxine treatment, both high and low S-TSH levels have been indicated to increase the risk of fragility fractures [4].…”

Section: Introductionmentioning

confidence: 99%

Case report: fast reversal of severe osteoporosis after correction of excessive levothyroxine treatment and long-term follow-up

Lainé

Landin‐Wilhelmsen

2017

Osteoporos Int

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SummaryThis case report describes a 38-year-old woman, who presented with bilateral femoral stress fractures and osteoporosis after years of excessive levothyroxine treatment. Her bone health was restored rapidly and long-lasting with the reduction of levothyroxine dosage. No bone-active treatment was warranted.IntroductionHyperthyroidism is a known risk factor for osteoporosis and fractures. Recent studies on patients with serum thyrotropin-suppressive therapy have not, however, indicated adverse effects on bone during long-term follow-up.MethodsThis case report describes long-term follow-up data of a clinically euthyreoid patient, who developed symptomatic osteoporosis due to excessive levothyroxine treatment.ResultsAfter correction of levothyroxine dosage, her bone mineral density (BMD) and previously elevated serum osteocalcin levels normalized rapidly and she remained free from fractures during 23 years of follow-up over menopause.ConclusionExcessive TSH suppression contributed to the secondary osteoporosis in this patient; BMD normalized after dose reduction of levothyroxine and no fractures occurred during 23 years’ follow-up. Some patients develop severe osteoporosis if they are over-substituted with levothyroxine, and decent follow-up of patients with levothyroxine supplementation is mandatory.

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“…In addition to their fluent exclusion criteria, we aimed to emphasize that possible thyroid dysfunctions may affect bone mineral mass [2,3]. The overall prevalence of hyperthyroidism, which is approximately 1.3 %, increases to 4-5 % in older women [4].…”

Section: To the Editorsmentioning

confidence: 99%

“…The authors suggested exclusion criteria as follows: had a history of neoplasia or had taken drugs that affect bone metabolism, including bisphosphonates, calcium and vitamin D supplements in the last 12 months or were receiving oral glucocorticoids (>10 mg/day prednisone or equivalent) in the last 3 months. In addition to their fluent exclusion criteria, we aimed to emphasize that possible thyroid dysfunctions may affect bone mineral mass [2,3]. The overall prevalence of hyperthyroidism, which is approximately 1.3 %, increases to 4-5 % in older women [4].…”

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confidence: 99%

Letter to: “Vitamin D levels and bone mass in rheumatoid arthritis”

2015

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may have a role in the results of the article by Brance et al. [1]. We hope that considering this condition would add to the value of the well-written article of Brance et al. [1] vitamin D levels and bone mass in RA. To the Editors, Conflict of interestWith great interest, we read the recent article by Brance et al.[1] vitamin D levels and bone mass in rheumatoid arthritis (RA). The authors discussed very clearly the relation between vitamin D and disease activity. They concluded that patients with RA had lower 25(OH)D levels than the control group and that low levels of 25(OH)D were related to moderate-high disease activity. Also, they found that bone mass was lower in the femoral neck of postmenopausal patients with RA. The authors suggested exclusion criteria as follows: had a history of neoplasia or had taken drugs that affect bone metabolism, including bisphosphonates, calcium and vitamin D supplements in the last 12 months or were receiving oral glucocorticoids (>10 mg/day prednisone or equivalent) in the last 3 months. In addition to their fluent exclusion criteria, we aimed to emphasize that possible thyroid dysfunctions may affect bone mineral mass [2,3]. The overall prevalence of hyperthyroidism, which is approximately 1.3 %, increases to 4-5 % in older women [4]. Because of the high prevalence among elderly population, we believe that the effect of thyroid hormones on bone metabolism This comment refers to the article available at

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A cross-sectional study to examine the correlation between serum TSH levels and the osteoporosis of the lumbar spine in healthy women with normal thyroid function

Abstract: In conclusion, our results suggest that low-normal serum TSH levels might be a potential risk factor for the osteoporosis of the lumbar spine in non-obese elderly women. But further prospective, large-scale, randomized controlled studies are warranted to establish our results.

Cited by 35 publications

References 29 publications

Lack of Influence of Thyroid Hormone on Bone Mineral Density and Body Composition in Healthy Euthyroid Women

Lack of Influence of Thyroid Hormone on Bone Mineral Density and Body Composition in Healthy Euthyroid Women

Case report: fast reversal of severe osteoporosis after correction of excessive levothyroxine treatment and long-term follow-up

Letter to: “Vitamin D levels and bone mass in rheumatoid arthritis”

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