J Bone Metab.  2019 Feb;26(1):31-38. 10.11005/jbm.2019.26.1.31.

Effects of Thyrotropin Suppression on Bone Health in Menopausal Women with Total Thyroidectomy

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 2Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. nmpnuh@naver.com
  • 3Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan Pusan National University Hospital, Yangsan, Korea.
  • 4Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 5Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea.
  • 6Department of Orthopaedic Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Abstract

BACKGROUND
This study examined the change in the trabecular bone score (TBS), areal bone mineral density (aBMD), and osteoporosis in postmenopausal women who underwent thyrotropin (TSH)-suppressive therapy for treating papillary thyroid cancer after a total thyroidectomy procedure.
METHODS
We evaluated 36 postmenopausal women who received a total thyroidectomy for papillary thyroid cancer and were undergoing TSH suppressive therapy with levothyroxine. Postmenopausal women (n=94) matched for age and body mass index were recruited as healthy controls. The aBMD and TBS of the lumbar spine were compared between dual energy X-ray absorptiometry (DXA) at baseline and at follow-up after an average of 4.92 years.
RESULTS
There was no significant difference in the rate of diagnoses of osteoporosis, osteopenia, or normal bone status between the 2 groups during the baseline DXA evaluation. However, the TBS was significantly lower whereas aBMD did not show significant difference at the time of baseline DXA measurement (1st DXA, 1.343±0.098 vs. 1.372±0.06317, P < 0.001; 2nd DXA, 1.342±0.095 vs. 1.370±0.062, P < 0.001). The TBS and aBMD did not differ significantly between the initial and follow-up DXA images in both groups of TSH suppressive patients and controls.
CONCLUSIONS
The average value of TBS and aBMD did not significantly change during the follow-up period. The TSH suppressive therapy was revealed as not a significant factor for the progressive deterioration of bone status during long term follow-up.

Keyword

Absorptiometry, photon; Bone density; Postmenopause; Thyroid neoplasms

MeSH Terms

Absorptiometry, Photon
Body Mass Index
Bone Density
Bone Diseases, Metabolic
Diagnosis
Female
Follow-Up Studies
Humans
Osteoporosis
Postmenopause
Spine
Thyroid Neoplasms
Thyroidectomy*
Thyrotropin*
Thyroxine
Thyrotropin
Thyroxine
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