Prevalence, Predictive Factors, and Characteristics of Osteoporosis in Hyperthyroid Patients

Ale, Ayotunde; Ogbera, Anthonia O; Ebili, Henry O; Adeyemo, Olusola L; Afe, Taiwo

doi:10.1155/2018/3540256

Cited by 11 publications

(10 citation statements)

References 29 publications

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“…A previous study in Nigerians among hyperthyroid patients has documented an osteoporosis rate of 45%. 34 Hyperthyroidism is an established risk factor of secondary osteoporosis, and an increased fracture risk as documented by this study.…”

Section: Discussionsupporting

confidence: 56%

Bone fractures among adult Nigerians with hyperthyroidism: risk factors, pattern and frequency

Ale

Odusan

Afe

et al. 2018

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Background: Hyperthyroidism is a common endocrine disorder with multi-systemic effects, the least reported of which is bone loss and fractures. Objective: The aim was to evaluate the risk factors, pattern and frequency of bone fractures among Nigerians with hyperthyroidism. Methodology: An analytical study was undertaken of 40 patients with hyperthyroidism aged between 21 and 50 years. They were seen at the outpatient Endocrine, Diabetic and Metabolism (EDM) clinic of Lagos State University Teaching Hospital (LASUTH). Using an interviewer-administered questionnaire, information on sociodemographics, medical history, clinical and biochemical parameters and dual-energy X-ray absorptiometry (DXA) scan was obtained. Risk of fracture was assessed using WHO and ISCD risk calculators. During statistical analysis, quantitative and qualitative data were expressed as mean (SD) and percentages. Results: In all, 40 patients with hyperthyroidism were studied with a mean age of 36.16 (8.43) years. There were 32 females (80%, female:male ratio 4:1) and mean body mass index was 24.14 (4.3) kg/m. Hyperthyroidism was defined by Waynes' scoring index greater than 19 and confirmed by elevated thyroid hormones (FT4 39.44 (24.11) (pmol/l), FT3 12.13 (7.83) (pmol/l)) and suppressed TSH 0.26 (0.03) (u/U/ml). Increased bone turnover was documented by elevated bone formation markers (osteocalcin 45.7 (19.9) ng/ml and alkaline phosphatase 221.1 (143.46 IU/l)), bone resorption markers (24-hour calcium excretion 590.95 (506.1) mg/day). The mean BMD T-and Z-scores were reduced-2.0 (1.2). Bone loss was observed in 31 (72.5%) hyperthyroid subjects, but only three (7.5%) had fractures due to minor trauma. Conclusion: Bone fractures may not be uncommon in hyperthyroidism. Early screening for bone diseases should be encouraged to improve treatment outcome.

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Section: Discussionsupporting

confidence: 56%

Bone fractures among adult Nigerians with hyperthyroidism: risk factors, pattern and frequency

Ale

Odusan

Afe

et al. 2018

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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“…Elevated FT4 and FT3 levels were associated with decreased BMD, and higher FT4 levels might accelerate the loss of the hip bone [ 41 , 42 ]. In the clinical study of Ale, the levels of FT3 and FT4 in the osteoporosis group and the osteopenia group were higher than those in the normal group [ 43 ]. In addition, TSH level is also one of the main pathogenic factors of osteoporosis [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Sensitivity to Thyroid Hormone Indices and Bone Mineral Density in US Males

Chen

Huang

Zhou

et al. 2022

International Journal of Endocrinology

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Objectives. Thyroid hormone is acknowledged as a pivotal factor in skeletal development and adult bone maintenance. However, available data about the relationship between sensitivity to thyroid hormone and bone mineral density (BMD) remain limited and conflicting. The purpose of the study was to explore the complex relationship between sensitivity to thyroid hormone indices and BMD using cross-sectional analysis. Methods. An overall sample of 3,107 males from the National Health and Nutrition Examination Survey (NHANES) was studied in the study. The thyroid hormone sensitivity indices included free triiodothyronine/tree thyroxine (FT3/FT4), thyroid-stimulating hormone index (TSHI), thyrotroph thyroxine resistance index (TT4RI), and thyroid feedback quantile-based index (TFQI). Given the complex study design and sample weights, the correlation between sensitivity to thyroid hormone indices and BMD was evaluated through multivariate linear regression models, and extra subgroup analyses were performed to examine the robustness of the results. Results. Among the 3,107 participants, we demonstrated that FT3/FT4 was negatively correlated with lumbar BMD (β = −0.0.35, 95% CI: −0.084–0.013, P < 0.05 ). In the terms of central sensitivity to thyroid hormone, TFQI showed a significant negative relationship with the BMD of the lumbar (β = −0.018, 95% CI: −0.033 to −0.003, P < 0.05 ), total femur (β = −0.020, 95% CI: −0.035 to −0.006, P < 0.01 ), and femur neck (β = −0.018, 95% CI: −0.031 to −0.005, P < 0.01 ). In the subgroup analyses stratified by body mass index (BMI), the significant negative correlation between TFQI and lumbar BMD remained in the male participants with BMI between 18.5 and 24.9 kg/m2. Conclusions. Decreased indices of sensitivity to thyroid hormones are strongly associated with increased lumbar BMD, suggesting that the dysfunction of peripheral and central response to thyroid hormone might contribute to bone loss. In addition, FT3/FT4 and TFQI were considered to be the preferable indicators to guide the prevention and clinical treatment of osteoporosis.

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“…Similar study was conducted by Ale and her colleagues [28]. This cross-sectional study included females and males between 22 and 50 years.…”

Section: Hyperthyroidism and Osteoporosismentioning

confidence: 67%

Thyroid Disorders and Osteoporosis

Ale¹

2021

Clinical Implementation of Bone Regeneration and Maintenance

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Adequate amount of thyroid hormone is an essential requirement for normal development and maturity of bones in the early life as well as for the maintenance of the skeletal system (bone remodeling). Osteoporosis, one of the most common metabolic bone disorders, is strongly associated with hyperthyroidism (endogenous and exogenous), whereas association of the same disease with hypothyroidism is not quite established. Most of the data describing the association between osteoporosis and hyperthyroidism are collected among elderly population (especially postmenopausal women), and only a few studies in literature researched into osteoporosis and hyperthyroidism in <50 years of age; hence further studies are required in the younger population (including premenopausal women and younger males).

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Prevalence, Predictive Factors, and Characteristics of Osteoporosis in Hyperthyroid Patients

Cited by 11 publications

References 29 publications

Bone fractures among adult Nigerians with hyperthyroidism: risk factors, pattern and frequency

Bone fractures among adult Nigerians with hyperthyroidism: risk factors, pattern and frequency

Association between Sensitivity to Thyroid Hormone Indices and Bone Mineral Density in US Males

Thyroid Disorders and Osteoporosis

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