Serum Osteocalcin Levels in Hyperthyroidism before and after Antithyroid Therapy

Abstract

Hyperthyroidism is characterized by accelerated bone turnover, caused from direct stimulation of bone cells by increased thyroid hormones. In this study, we aimed to investigate serum osteocalcin levels as a bone formation marker, before antithyroid (propylthiouracil) therapy at hyperthyroid stage and after antithyroid therapy at euthyroid stage of the patients. Twenty four hyperthyroid patients (18 females, 6 males) and 20 (13 females, 7 males) healthy controls were included into this study. Blood and urine samples were taken before medical treatment at hyperthyroid state, and after the antithyroid therapy until the patients reached the euthyroid state. Serum alkaline phosphatase, osteocalcin, calcium, phosphorus, Free T3, Free T4, TSH and urine calcium/creatinine levels were assessed. We found a significant decrease in serum osteocalcin (p=0.006), urinary calcium/ creatinine (p=0.004), and serum phosphorus (p=0.038) levels in euthyroid state in comparison to hyperthyroid state. The increases in serum bone formation marker osteocalcin and bone resorption marker urinary calcium/creatinine levels in hyperthyroid state compared to euthyroid state in our study confirmed that hyperthyroid patients have high bone turnover. We conclude that, hyperthyroid patients has high bone turnover of formation and resorption even after attainment of euthyroidism. Osteocalcin and urine calcium/creatinine are sensitive markers in documenting bone remodeling during treatment of hyperthyroidism. bone turnover; hyperthyroidism; osteocalcin

OPYT PRIMENENIYa PROFILAKTIChESKOY DOZY ALENDRONATA (FOSAMAKS 35 mg) DLYa LEChENIYa OSTEOPOROZA u zhenshchin v postmenopauzes subklinicheskim tireotoksikozom

“…Известно, что компенсация манифестного тиреотоксико-за приводит к нормализации костного метаболизма [5,8,33,41,47,52] и восстановлению МПК [27, 33,41,45,47], хотя не всегда удаётся достичь показателей МПК до заболевания [27]. Восстановление эутиреоза при эндогенном субклини-ческом тиреотоксикозе также приводит к нормализации кос-тного обмена [37] и предотвращает потерю МПК у женщин в постменопаузе [18].…”

Surgical Management of Hyperthyroidism

“…This is thought to be due to a reduction in respiratory muscle mass and strength with a corresponding reduction in the vital capacity [18]. Bone turnover is also increased in the thyrotoxic state due to the direct stimulation of osteoclasts and osteoblasts to increase bone resorption [27,28]. Low TSH levels, of themselves, have also been implicated in the dysregulation of bone turnover [29].…”

Thyroid Hormone and the Skeleton

“…Thyrotoxicosis is associated with increased serum concentrations of osteocalcin [52][53][54][55][56][57], alkaline phosphatase [58][59][60], and osteoprotegerin [61]. Despite increased osteoblastic activity, the enhanced bone formation cannot compensate for thyroid hormone-induced increments in bone resorption.…”

“…The levels of these markers of bone turnover correlate with circulating levels of thyroid hormones [65]. Treatment of thyrotoxicosis is associated with normalization of these biochemical markers of bone turnover [56,[59][60][61]64,65].…”