Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism

Barbosa, Ana Paula; Mascarenhas, Mário Rui; Silva, Carlos Francisco; Távora, Isabel; Bicho, Manuel; Carmo, Isabel do; Oliveira, António Gouveia

doi:10.1530/eje-14-0602

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…In our present study men were aged more than 50 years and the scans were performed at the radius 1/3 or 33%. A previous study by our group in younger hyperthyroid men, showed significant BMD decreases in all skeletal regions and an increase in the prevalence of vertebral fractures detected by VFA [17] .…”

Section: Discussionsupporting

confidence: 46%

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The main autoimmune and nonautoimmune etiologies of endogenous hyperthyroidism do not seem to influence the increased prevalence of morphometric vertebral fractures and osteoporosis in Portuguese men

Barbosa

Mascarenhas

Bicho

et al. 2017

Osteoporosis and Sarcopenia

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ObjectivesThe purpose of this study was to evaluate the effects of hyperthyroidism and their etiology on bone mineral density (BMD), on body soft tissue composition, on the prevalence of vertebral fractures detected by vertebral fracture assessment (VFA) and on the trabecular bone score (TBS).MethodsFrom an initial population of 119 Portuguese men (78 with hyperthyroidism [HT]+ 41 controls [CTs]) admitted to the Endocrinology Department we selected 41 men aged over 50 with clinical hyperthyroidism to participate; each one was matched by age and height with a control person. BMD (g/cm2) at the lumbar spine, hip, radius 33% and whole body and the total body masses (kg) were studied by dual-energy X-ray absorptiometry (DXA). VFA with Genant semiquantitative method was used to detect fractures. The TBS was obtained from lumbar spine DXA images. No patient had been treated previously for hyperthyroidism or osteoporosis. Adequate statistical tests were used.ResultsIn the hyperthyroidism group, total lean mass (CT 58.16 ± 7.7 vs. HT 52.3 ± 5.7, P = 0.03) and distal radius BMD (CT 0.769 ± 0.05 vs. HT 0.722 ± 0.08, P = 0.005) were lower; there was a significantly higher prevalence of osteoporosis (CT 9.7% vs. HT 29.3%, P = 0.015) and vertebral fractures (CT 2.4% vs. HT 24.4%, P = 0.007). TBS was similar in both groups (CT 1.328 ± 0.11 vs. HT 1.356 ± 0.11, P = not significant). Comparing patients with Graves' disease with patients with toxic goiter, there were no differences regarding BMD, BMD qualification, prevalence of fractures and TBS and just total lean mass was significantly lower in patients with Graves' disease.ConclusionsThese results suggest that in a group of hyperthyroid men aged over 50 there are significant decreases in cortical bone BMD and lean mass and a higher prevalence of osteoporosis and silent vertebral fractures, but the etiology of the hyperthyroidism does not seem to influence it. Besides the antithyroid drugs, some patients may benefit from bone-directed treatments.

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Section: Discussionsupporting

confidence: 46%

“…Despite not being used routinely in our country and in other bone metabolic units around the world, we find it very useful in clinical practice to detect prevalent fractures [14] , [15] , [16] . A previous study by our group in young hyperthyroid men, showed an increased prevalence of vertebral fractures detected by VFA [17] .…”

Section: Introductionmentioning

confidence: 52%

The main autoimmune and nonautoimmune etiologies of endogenous hyperthyroidism do not seem to influence the increased prevalence of morphometric vertebral fractures and osteoporosis in Portuguese men

Barbosa

Mascarenhas

Bicho

et al. 2017

Osteoporosis and Sarcopenia

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“…Due to the fact that hyperthyroidism can cause osteoporosis [ 74 ], there have been proposals to consider BMD as a standard test in patients with newly diagnosed hyperthyroidism to identify groups in need of further monitoring [ 75 ]. There are various studies in which hyperthyroidism led to a decrease in bone density [ 75 , 76 , 77 , 78 ]. Additionally, the risk of fracture is increased [ 79 ] in the first five years after the diagnosis of hyperthyroidism.…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism and Wnt Signaling Pathway: Influence on Bone Remodeling

et al. 2023

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Graves’ disease is an autoimmune disease of the thyroid gland, characterized by increased production of thyroid hormones, which can affect many different organ systems in the body. Among other problems, it can cause disorders of the skeletal system, shortening the bone remodeling cycle and causing a decrease in bone density. The Wnt cascade signaling pathway and the β-catenin, as a part of the canonical Wnt pathway, also play roles in maintaining bone mass. Inhibition of the Wnt pathway can cause bone loss, and its stimulation can increase it. The Wnt signaling pathway influences the effectiveness of thyroid hormones by affecting receptors for thyroid hormones and deiodinase, while thyroid hormones can change levels of β-catenin within the cell cytoplasm. This indicates that the Wnt pathway and thyroid hormone levels, including hyperthyroidism, are linked and may act together to change bone density. In this review article, we attempt to explain the interplay between thyroid hormones and the Wnt pathway on bone density, with a focus on directions for further research and treatment options.

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“…We have also showed that young men with endogenous hyperthyroidism have an increase in the prevalence of reduced bone mass and osteoporosis and even asymptomatic vertebral fractures detected by VFA (Vertebral Fracture Assessment) [21,22].…”

Section: L-thyroxinementioning

confidence: 99%

Iatrogenic Osteoporosis

Barbosa

Mascarenhas

2021

Mìžnarodnij endokrinologìčnij žurnal

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The literature review provides information on the major calcium-regulating hormones and their role in the regulation of bone remodeling. These processes are also influenced by sex steroids, growth hormone, insulin, cortisol, thyroid hormones and various local growth factors. In this regard, osteopenia and osteoporosis are closely linked to a number of endocrine diseases, some of which are common (diabetes mellitus, hyperthyroidism), others -quite rare (endogenous hypercortisolism). Osteoporosis associated with diabetes, steroid osteoporosis, osteoporosis in thyroid function abnormality are considered in detail. It is emphasized that timely diagnosis and adequate treatment of endocrine diseases associated with a decrease in bone mineral density, contribute to slowing or stopping bone loss, normalization of bone remodeling, enables to reduce the incidence of fractures and to improve the quality of life of the patient.

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Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism

Cited by 6 publications

References 32 publications

The main autoimmune and nonautoimmune etiologies of endogenous hyperthyroidism do not seem to influence the increased prevalence of morphometric vertebral fractures and osteoporosis in Portuguese men

The main autoimmune and nonautoimmune etiologies of endogenous hyperthyroidism do not seem to influence the increased prevalence of morphometric vertebral fractures and osteoporosis in Portuguese men

Hyperthyroidism and Wnt Signaling Pathway: Influence on Bone Remodeling

Iatrogenic Osteoporosis

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