Hip bone mineral density, bone turnover and risk of fracture in patients on long-term suppressive L-thyroxine therapy for differentiated thyroid carcinoma
Hip bone mineral density, bone turnover and risk of fracture in patients on long-term suppressive L-thyroxine therapy for differentiated thyroid carcinoma
复制标题
DOI：
10.1530/eje.1.01933
复制
发表时间：
2005-07-01
影响因子：
5.8
通讯作者：
Wolffenbuttel, BHR
中科院分区：
文献类型：
--
作者：
Heijckmann, AC;Huijberts, MSP;Wolffenbuttel, BHR
目的：未经治疗的甲亢和高剂量甲状腺激素治疗与骨质疏松症有关。然而，在骨质疏松症的其他临床危险因素和椎体骨折患病率的背景下，它们对骨转换的影响、对骨密度（BMD）的贡献并没有很好的文献记载。设计：横断面研究。方法：对59例接受l -甲状腺素抑制治疗的分化型甲状腺癌（DTC）患者进行研究。通过双x线骨密度仪（DXA）测量髋部骨密度，并进行腰椎和胸椎的侧位DXA图像。采用I型胶原c -末端肽（ICTP）测定骨吸收，采用I型前胶原n -前肽（PINP）测定骨形成。骨质疏松症的临床危险因素采用问卷评估。结果：女性和男性的BMD z评分与NHANES (National Health and Nutrition Examination Survey) III参照组相似，长期I（bbb10年）抑制治疗后也是如此。骨密度最低和最高四分位数的患者在临床危险因素的存在方面存在显著差异。ICTP水平显著高于同龄对照组，PINP水平无显著差异。我们发现了4例普遍的椎体骨折患者。结论：我们的结论是，分化良好的甲状腺癌患者发生低骨量的风险没有增加，也没有较高的椎体骨折发生率，至少在使用相对低剂量的l-甲状腺素治疗时是如此。
Objective: Untreated hyperthyroidism and treatment with high doses of thyroid hormone are associated with osteoporosis. However, their effect on bone turnover, their contribution to bone mineral density (BMD) in the context of other clinical risk factors for osteoporosis and the prevalence of vertebral fractures is not well documented.Design: Cross-sectional study.Methods: We studied 59 patients receiving L-thyroxine suppressive therapy for differentiated thyroid carcinoma (DTC). BMD of the hip was measured by dual X-ray absorptiometry (DXA) and lateral DXA pictures of the lumbar and thoracic vertebrae were performed. Bone resorption was measured by C-telopeptides of type I collagen (ICTP) and bone formation by procollagen type I N-propeptide (PINP). Clinical risk factors for osteoporosis were evaluated using a questionnaire.Results: Z-scores of BMD were similar as the NHANES (National Health and Nutrition Examination Survey) III reference group in women and men, also after long-term I(> 10 years) suppression therapy. Patients in the lowest and highest quartile of BMD showed significant differences in the presence of clinical risk factors. ICTP levels were significantly higher than in age-matched controls, PINP levels were not different. We found four patients with a prevalent vertebral fracture.Conclusions: We conclude that patients with well-differentiated thyroid carcinoma are not at increased risk of developing low bone mass nor have a higher prevalence of vertebral fracture at least when treated with relatively low doses Of L-thyroxine.