Prevalence of Fractures in Postmenopausal Women with Thyroid Disease

Solomon, Barbara; Wartofsky, Léonard; Burman, Kenneth D.

doi:10.1089/thy.1993.3.17

Cited by 138 publications

(68 citation statements)

References 15 publications

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“…Of note, in that study, the risk for hospitalization because of fracture was approximately twofold greater in persons older than 65 years of age with low TSH levels. Another retrospective study (19) found that women with a history of hyperthyroidism or thyroid cancer appeared to have their first fracture earlier than women without thyroid disease, and two recent case-control studies of endogenous hyperthyroidism and fracture had conflicting results (21,48).…”

Section: Discussionmentioning

confidence: 99%

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

et al. 2001

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“…In a study based upon interviews of 300 white postmenopausal women, no increased fracture risk was found in women taking L-T4 (101). In a study of 1180 patients treated with L-T4, the overall fracture rate in women over 65 years after 5 years was 2.5% in those with low TSH, and 0.9% in those with normal TSH values; the difference was not statistically significant (102).…”

Section: Bone Structure and Metabolismmentioning

confidence: 95%

Subclinical hyperthyroidism: clinical features and treatment options

et al. 2005

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Subclinical hyperthyroidism appears to be a common disorder. It may be caused by exogenous or endogenous factors: excessive TSH suppressive therapy with L-thyroxine (L-T4) for benign thyroid nodular disease, differentiated thyroid cancer, or hormone over-replacement in patients with hypothyroidism are the most frequent causes. Consistent evidence indicates that 'subclinical' hyperthyroidism reduces the quality of life, affecting both the psycho and somatic components of well-being, and produces relevant signs and symptoms of excessive thyroid hormone action, often mimicking adrenergic overactivity. Subclinical hyperthyroidism exerts many significant effects on the cardiovascular system; it is usually associated with a higher heart rate and a higher risk of supraventricular arrhythmias, and with an increased left ventricular mass, often accompanied by an impaired diastolic function and sometimes by a reduced systolic performance on effort and decreased exercise tolerance. It is well known that these abnormalities usually precede the onset of a more severe cardiovascular disease, thus potentially contributing to the increased cardiovascular morbidity and mortality observed in these patients. In addition, it is becoming increasingly apparent that subclinical hyperthyroidism may accelerate the development of osteoporosis and hence increased bone vulnerability to trauma, particularly in postmenopausal women with a pre-existing predisposition. Subclinical hyperthyroidism and its related clinical manifestations are reversible and may be prevented by timely treatment.European Journal of Endocrinology 152 1-9

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“…Some reports, including a meta-analysis by Wü ster (9), have suggested that the bone mineral density (BMD) is reduced in patients taking long-term treatment to suppress thyroid stimulating hormone (TSH) (levothyroxine, L-T 4 ) compared with controls (10-13). However, other studies have failed to confirm this decremental effect of L-T 4 treatment on BMD (14)(15)(16)(17) or on the prevalence of fracture (18,19). L-T 4 treatment that does not suppress TSH seems to have little effect on bone (20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

The effect of long-term, non-suppressive levothyroxine treatment on quantitative ultrasonometry of bone in women

Hadji

Hars²,

Sturm³

et al. 2000

European Journal of Endocrinology

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Objective: To evaluate the impact of long-term, non-suppressive levothyroxine (L-T 4 ) treatment on quantitative ultrasonometry in women.Design: This was a case-control study. Subjects and methods: Altogether 667 women (mean age Ϯ S.D., 49.5 Ϯ 13.1 years) were studied. Of these, 156 (23%) had non-toxic goitre or hypothyroidism and had been taking L-T 4 (75-100 mg/day) for at least 5 years (mean Ϯ S.D., 12.5 Ϯ 7.5 years); the remaining 511 (77%) women were not receiving L-T 4 . All women had completed a questionnaire on risk factors for thyroid dysfunction and osteoporosis, and those with diseases or treatments known to effect bone metabolism -other than thyroxine or hormone replacement therapy (HRT) -were excluded. Women underwent quantitative ultrasonometry (QUS) at the heel. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and the stiffness index (SI) were compared, first, in all women taking L-T 4 and controls and, secondly, in women taking L-T 4 and controls pair-matched for age, weight, body mass index (BMI), menopausal status and HRT use. Results: Even after matching for age, weight, BMI, menopausal and HRT status, women taking L-T 4 had significantly lower values for SOS and SI (P < 0.05), but not for BUA. However, absolute T-and Z-scores for SI were not low in either the study or control groups. Lower values were associated, but not significantly so, with years since the menopause and duration of L-T 4 treatment. Conclusions: Long-term, non-suppressive L-T 4 treatment in women with goitre or hypothyroidism was associated with a slight reduction in QUS values, which was more pronounced in postmenopausal women. This group could be at higher risk for osteoporotic fracture.

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Prevalence of Fractures in Postmenopausal Women with Thyroid Disease

Cited by 138 publications

References 15 publications

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

Risk for Fracture in Women with Low Serum Levels of Thyroid-Stimulating Hormone

Subclinical hyperthyroidism: clinical features and treatment options

The effect of long-term, non-suppressive levothyroxine treatment on quantitative ultrasonometry of bone in women

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