Osteoporos Sarcopenia.  2016 Sep;2(3):175-179. 10.1016/j.afos.2016.05.004.

Changes in bone mineral density and trabecular bone score in Graves' disease patients after anti-thyroid therapy

Affiliations
  • 1Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea.
  • 2Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea. colsmile@hanmail.net

Abstract


OBJECTIVE
The purpose of this study was to evaluate changes in bone quantity based on bone mineral density (BMD) and bone quality based on trabecular bone score (TBS) in Graves' disease patients after anti-thyroid therapy. RESEARCH DESIGN AND METHOD: This retrospective study included premenopausal female and male patients with Graves' disease who received BMD measurement more than two times during treatment. BMD and thyroid function tests with free thyroxine (FT4), total triiodothyronine (T3), thyroid stimulating hormone (TSH), and TSH receptor antibody (TRAb) levels were collected two times during follow-up. TBS was calculated using TBS insight® software (version 2.1) from dual-energy X-ray absorptiometry images.
RESULTS
Thirty Graves' disease patients (17 males, 56%; 13 premenopausal females, 44%) with a mean age of 35.3 ± 9.9 years were included. The mean follow-up period was 20.7 ± 8.5 months. The median levels of FT4, TSH and TRAb improved at follow-up [2.55 ng/dL (Interquartile range (IQR) 2.07-3.78) to 1.28 ng/dL (IQR 1.23-1.39), 0.015 mIU/L (IQR 0.01-0.04) to 0.89 mIU/L (IQR 0.35-1.55), 17.0 IU/L (IQR 5.0-40.3) to 5.0 IU/L (5.0-6.0), respectively; p < 0.001]. Median BMD (lumbar spine) values also improved from 1.118 g/cm² (IQR 1.000-1.119) to 1.167 g/cm² (IQR 1.050-1.219) ( p = 0.001) at follow-up. TBS increased from 1.377 (IQR 1.299-1.422) to 1.390 (IQR 1.327-1.430) after treatment ( p = 0.038).
CONCLUSIONS
Both bone quality and density improved after anti-thyroid treatment in premenopausal female and male Graves' disease patients.

Keyword

Graves' disease; Bone mineral density; Trabecular bone score

MeSH Terms

Absorptiometry, Photon
Bone Density*
Female
Follow-Up Studies
Graves Disease*
Humans
Male
Methods
Receptors, Thyrotropin
Research Design
Retrospective Studies
Thyroid Function Tests
Thyrotropin
Thyroxine
Triiodothyronine
Receptors, Thyrotropin
Thyrotropin
Thyroxine
Triiodothyronine
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