| dc.description.abstract | Objectives: Endogenous hyperthyroidism accelerates bone turnover and shortens the normal bone remodeling cycle, which results in reduced
bone density. It is estimated that suppressive levothyroxine (LT4) therapy also decreases bone density. The aim of this study was to define risk
factors for osteoporosis development in patients under thyrotropin-stimulating hormone (TSH) suppressive treatment for differentiated thyroid
cancer (DTC).
Methods: Patients with a diagnosis of low or intermediate risk group DTC according to the American Thyroid Association 2015 guidelines and
who have been receiving LT4 suppression therapy and were physically fit to undergo femur and lumbar vertebra bone density study were included
in the study. Patients lacking information on demographic data, medical history, preoperative thyroid hormone status, or routine follow-up data
were excluded from the study. A study form consisting of patient information on possible risk factors for osteoporosis such as gender, age,
menopausal status, smoking, family history of osteoporosis, preoperative thyroid hormone status, postoperative hypoparathyroidism history,
mean serum TSH levels, and duration of TSH suppression was created and filled out for each participant. Bone mineral densitometries of the femur
and lumbar vertebrae were measured along with serum vitamin D and parathyroid hormone levels.
Results: During TSH suppression (mean 7.2±4.5 years, range: 1-26), osteoporosis was detected in 89 (9.6%) patients. The mean time to develop
osteoporosis was significantly different in patients with or without a family history of osteoporosis (15.3±0.4 versus 20.3±0.6 years; p=0.002).
Similarly, the mean time to develop osteoporosis for was found to be significantly shorter in postmenopausal patients than that for premenopausal
women (18.6±0.7 versus 20.4±0.4 years; p<0.001). Male gender (p<0.001), a family history of osteoporosis (p=0.001) and menopausal state
(p<0.001) were identified as independent predictive factors for developing osteoporosis.
Conclusion: Postmenopausal women, men, and patients with a family history who receive TSH-suppression treatment have a tendency to
develop osteoporosis.
Keywords: Differentiated thyroid carcinoma, osteoporosis, thyroid-stimulating hormone suppression treatment | tr_TR |
