Serum osteoprotegerin and soluble receptor activator of nuclear factor κB ligand levels in patients with a history of differentiated thyroid carcinoma: a case-controlled cohort study

Giusti, Massimo; Cecoli, Francesca; Fazzuoli, Laura; Franchis, V. De; Ceresola, Enrica; Ferone, Diego; Mussap, Michele; Minuto, Francesco

doi:10.1016/j.metabol.2007.01.004

Cited by 10 publications

(8 citation statements)

References 52 publications

(89 reference statements)

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“…In all but 6 studies,25,27–31 the control groups were comprised of healthy euthyroid-matched individuals or local reference populations. In 2 studies,28,30 the control group suffered from benign thyroid disease. Women with known osteoporosis suffering with DTC were compared with those with osteoporosis but no DTC in one case,29 and women with DTC and THST were compared with those with DTC but no THST (with the aim of euthyroidism) in two cases 25,27.…”

Section: Discussionmentioning

confidence: 99%

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Parker¹,

Edafe²,

Balasubramanian³

2017

POR

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BackgroundDifferentiated thyroid cancer (DTC) occurs in relatively young patients and is associated with a good prognosis and long survival. The management of this disease involves thyroidectomy, radioiodine therapy, and long-term thyroid-stimulating hormone suppression therapy (THST). The long-term effects of the treatment and the interaction between subclinical hyperthyroidism and long-term hypoparathyroidism are poorly understood. This review sought to examine the available evidence.MethodsA PubMed search was carried out using the search terms “Thyroid Neoplasms” AND (“Thyroxine” OR “Hypocalcemia” OR “Thyrotropin”). Original English language articles published in the last 30 years studying the morbidity from thyroid-stimulating hormone (TSH) suppression and hypoparathyroidism following a surgery for DTC were retrieved and reviewed by 2 authors.ResultsOf the 3,000 results, 66 papers including 4,517 patients were selected for the present study. Studies reported on a range of skeletal (included in 34 studies, 1,647 patients), cardiovascular (17 studies, 957 patients), psychological (10 studies, 663 patients), and other outcomes (10 studies, 1,348 patients). Nine of 26 studies on patients who underwent THST showed a reduction in bone density, and 13 of 23 studies showed an increase in bone turnover markers. Skeletal effects were more marked in postmenopausal women. There was no evidence of increased fracture risk, and only little data were available on hypoparathyroidism. Four of five studies showed an increased left ventricular mass index on echocardiography, and one study showed a higher prevalence of atrial fibrillation (AF). There was little difference in basic physiological parameters and limited literature regarding symptoms or significant events. Six studies showed associations between long-term TSH suppression and impaired quality of life. Impaired glucose metabolism and prothrombotic states were also found in DTC patients.ConclusionThere is limited literature regarding long-term DTC treatment-related morbidity, particularly regarding the effects of long-term hypocalcemia. Most studies have focused on surrogate markers and not on clinical outcomes. A large prospective study on defined clinical outcomes would help characterize the morbidity of treatment and stimulate research on tailoring treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Parker¹,

Edafe²,

Balasubramanian³

2017

POR

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“…Alterations in serum OPG levels have been described in both hyper-and hypothyroidism 17,18 but, in our experience, OPG and RANK-L levels are comparable in patients with a history of DTC and suppressed endogenous TSH on L-T4, and in those with a history of non-malignant thyroid diseases. 37 By contrast, other authors have recently reported an increase in OPG and a decrease in RANK-L levels in DTC patients in comparison with age-matched normal subjects. 19 In our study, rhTSH was administered both to subjects with slight hyperthyroxinemia and to those in whom L-T4 had previously been reduced for diagnostic purposes.…”

Section: Discussionmentioning

confidence: 85%

Recombinant human thyroid stimulating hormone does not acutely change serum osteoprotegerin and soluble receptor activator of nuclear factor-?? ligand in patients under evaluation for differentiated thyroid carcinoma*

Giusti

Cecoli

Ghiara

et al. 2007

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ObJEctIVE: some extra-thyroid actions of thyroid stimulating hormone (tsH), such as an in vitro action on bone, have been described. Our aim was to evaluate in vivo the acute effect of a recombinant human tsH (rhtsH)-induced tsH surge on Osteoprotegerin (OPG) and receptor activator of the nuclear factor-κb (rANK-L) levels in patients under levo-thyroxine (L-t4) therapy. DEsIGN: 24 patients with differentiated thyroid carcinoma (Dtc) were studied. standard rhtsH testing was performed. OPG, rANK-L, tsH, thyroid hormones, thyroglobulin and several parameters of bone metabolism were evaluated. rEsuLts: baseline OPG and rANK-L levels were in the range of our reference population. An inverse correlation between OPG and spinal Z-score (p=0.029) and between rANK-L and age (p=0.018) or urinary calcium/creatinine ratio (p=0.011) was detected. After rhtsH administration, a significant (p<0.001) increase in tsH was found. No significant increase in OPG or rANK-L levels after rhtsH was observed. No correlation was detected between tsH peak value after rhtsH and maximal percentage change in OPG or rANK-L. A slight increase in urinary cross-links after rhtsH was found. cONcLusIONs: In a small group of subjects with a history of Dtc on Lt4 regimen, our study did not support an acute direct effect of tsH on OPG and rANK-L.

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“…On the other hand, there are also studies reporting that thyroid status does not affect OPG and RANKL levels. Giusti et al showed that OPG and RANKL levels were similar in patients with different LT4 doses and thyroid hormone levels [11]. Another study showed that recombinant TSH did not affect OPG and RANKL levels in DTC [21].…”

Section: Discussionmentioning

confidence: 98%

“…The clinical implications of this slow turnover in hypothyroidism have been conflicting and the influence of hypothyroidism on bone metabolism still remains poorly understood [8][9][10]. Recent studies suggested that thyroid disorders might influence serum OPG and RANKL levels [11][12][13][14]. Hypothyroid patients were reported to have higher concentrations of OPG compared to euthyroid controls [12][13][14] and that increase returned to normal once thyroid function had been normalized with levothyroxine (LT4) replacement [13,14].…”

Section: Introductionmentioning

confidence: 99%

RANKL/Osteoprotegerin System and Bone Turnover in Hashimoto Thyroiditis

et al. 2016

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Hypothyroidism is associated with changes in bone metabolism. The impact of hypothyroidism and the associated autoimmunity on the mediators of bone turnover in Hashimoto's thyroiditis (HT) is not known. In this study, we assessed the levels of OPG, RANKL, and IL-6 along with markers of bone formation as osteocalcin (OC) and markers of bone resorption as type 1 collagen C telopeptide (CTX) and tartrate-resistant acid phosphatase isoform 5b (TRAcP 5b) in 30 hypothyroid and 30 euthyroid premenopausal HT patients and 20 healthy premenopausal controls. We found that TRAcP 5b (p = 0.006), CTX (p = 0.01), OC (p = 0.017), and IL-6 (p < 0.001) levels were lower in the hypothyroid group compared to euthyroid HT patients and controls. OPG levels were higher (p < 0.001) and RANKL levels were lower (p = 0.021) in hypothyroid and euthyroid HT patients compared to controls. TSH was negatively correlated with IL-6 (rho = -0.434, p < 0.001), OC (rho = -0.313, p = 0.006), TRAcP 5b (rho = -0.335, p = 0.003), and positively correlated with OPG (rho = 0.248, p = 0.029). RANKL/OPG ratio was independently associated with the presence of HT. In conclusion, bone turnover is slowed down by hypothyroidism in premenopausal patients with HT. Thyroid autoimmunity might have a unique impact on OPG/RANKL levels apart from the resultant hypothyroidism.

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Serum osteoprotegerin and soluble receptor activator of nuclear factor κB ligand levels in patients with a history of differentiated thyroid carcinoma: a case-controlled cohort study

Cited by 10 publications

References 52 publications

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Recombinant human thyroid stimulating hormone does not acutely change serum osteoprotegerin and soluble receptor activator of nuclear factor-?? ligand in patients under evaluation for differentiated thyroid carcinoma*

RANKL/Osteoprotegerin System and Bone Turnover in Hashimoto Thyroiditis

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