J Endocr Surg.  2017 Dec;17(4):153-159. 10.16956/jes.2017.17.4.153.

Bone Mineral Density in Thyroid Cancer Patients: Data from the Korea National Health and Nutrition Examination Survey

• Chang MC

• KMID: 2397992
• DOI: http://doi.org/10.16956/jes.2017.17.4.153

Abstract

PURPOSE
There are conflicting results about bone mineral density (BMD) after thyroid-stimulating hormone (TSH) suppression in thyroid cancer treatment. This study used the Korea National Health and Nutrition Examination Survey (KNHANES) data to investigate BMD of thyroid cancer patients in Korea.
METHODS
The data were collected from 2008 to 2011 of the KNHANES IV-V. Among a total of 37,753 participants, 18,618 subjects were included. Osteopenia and osteoporosis were evaluated according the past history of thyroid cancer. Subgroups of women and post-menopausal women were analyzed using the same method.
RESULTS
Among the 18,618 subjects, 80 thyroid cancer cases were observed. There was no significant difference in osteopenia and osteoporosis with or without thyroid cancer history (P=0.783). In the subgroup analyses of women, no difference was observed in BMD according thyroid cancer history (P=0.685). In the post-menopausal women, osteopenia and osteoporosis were less frequent in thyroid cancer cases in univariate analysis (P=0.003), but that was not significant in multivariate analysis (P=0.095).
CONCLUSION
Although the KNHANES had a small number of thyroid cancer cases, no data about TSH suppression, and short follow-up periods, no significant difference in BMD with or without thyroid cancer was observed. The subgroup analyses of women and post-menopausal women showed similar results.

Keyword

Thyroid neoplasms; Bone density; Osteoporosis

MeSH Terms

Bone Density*
Bone Diseases, Metabolic
Female
Follow-Up Studies
Humans
Korea*
Methods
Multivariate Analysis
Nutrition Surveys*
Osteoporosis
Thyroid Gland*
Thyroid Neoplasms*
Thyrotropin
Thyrotropin

Reference

1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016; 26:1–133.

2. Nicholls JJ, Brassill MJ, Williams GR, Bassett JH. The skeletal consequences of thyrotoxicosis. J Endocrinol. 2012; 213:209–221.

3. Park KS. TSH suppression after differentiated thyroid cancer surgery and osteoporosis. Korean J Endocr Surg. 2016; 16:1–5.

4. Lee MY, Park JH, Bae KS, Jee YG, Ko AN, Han YJ, et al. Bone mineral density and bone turnover markers in patients on long-term suppressive levothyroxine therapy for differentiated thyroid cancer. Ann Surg Treat Res. 2014; 86:55–60.

5. Kim CW, Hong S, Oh SH, Lee JJ, Han JY, Hong S, et al. Change of bone mineral density and biochemical markers of bone turnover in patients on suppressive levothyroxine therapy for differentiated thyroid carcinoma. J Bone Metab. 2015; 22:135–141.

6. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, et al. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol. 2014; 43:69–77.

7. Lee IS, Leem AY, Lee SH, Rhee Y, Ha Y, Kim YS. Relationship between pulmonary function and bone mineral density in the Korean National Health and Nutrition Examination Survey. Korean J Intern Med. 2016; 31:899–909.

8. Takamura Y, Miyauchi A, Yabuta T, Kihara M, Ito Y, Miya A. Attenuation of postmenopausal bone loss in patients with transient hypoparathyroidism after total thyroidectomy. World J Surg. 2013; 37:2860–2865.

9. Murphy E, Williams GR. The thyroid and the skeleton. Clin Endocrinol (Oxf). 2004; 61:285–298.