Serum TSH values and risk of vertebral fractures in euthyroid post-menopausal women with low bone mineral density

Context: The hormonal factors involved in the regulation of peak bone mass (PBM) in men have not been fully investigated. Apart from gonadal steroids and somatotropic hormones, thyroid hormones are known to affect bone maturation and homeostasis and are additional candidate determinants of adult bone mass. Objective: We aimed to investigate between-subject physiological variation in free and total thyroid hormone concentrations, TSH, and thyroid binding globulin (TBG) in relation to parameters of bone mass, geometry, and mineral density in healthy men at the age of PBM. Design and setting: We recruited 677 healthy male siblings aged 25-45 years in a cross-sectional, population-based study. Areal and volumetric bone parameters were determined using dual-energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT). Total and free thyroid hormones, TBG, and TSH were determined using immunoassays. Results: Free and total thyroid hormone concentrations were inversely associated with bone mineral density (BMD) and bone mineral content (BMC) at the hip and total body (free triiodothyronine (FT 3 ), total T 3 (TT 3 ), and total T 4 (TT 4 )) and at the spine (FT 3 ). TBG was negatively associated with BMC and areal BMD at all sites. At the radius, cortical bone area was inversely associated with TT 3 , TT 4 , and TBG, and trabecular bone density was inversely associated with free thyroxine, TT 4 , and TBG. We observed inverse associations between cortical bone area at the mid-tibia and FT 3 , TT 3 , TT 4 , and TBG. No associations between TSH and DXA or pQCT measurements were found. Conclusion: In healthy men at the age of PBM, between-subject variation in thyroid hormone concentrations affects bone density, with higher levels of FT 3 , TT 3 , TT 4 , and TBG being associated with less favorable bone density and content.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Thyroid hormone status within the physiological range affects bone mass and density in healthy men at the age of peak bone mass

Roef

Lapauw

Goemaere

et al. 2011

“…Furthermore, thyrotropin (TSH) is a negative regulator of bone remodeling, inhibiting the formation and survival of osteoclasts and the differentiation of osteoblasts (3). Also, it has been proposed that low TSH levels, per se, can predispose to osteoporosis and fragility fractures (4,5,6). However, the studies investigating the effects of endogenous subclinical hyperthyroidism on the skeleton are scarce, with most of them reflecting the effect of supraphysiologic doses of thyroid hormone to suppress TSH secretion in the treatment of differentiated thyroid carcinoma or nontoxic goiter and providing conflicting results (7).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism

Barbosa¹,

Mascarenhas²,

Silva³

et al. 2015

Background: Hyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure. Objectives: This study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism. Design: We conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (nZ24) and control (nZ24) groups. Materials and methods: A group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (nZ24) and control (nZ24) groups. BMD (g/cm 2 ) at L 1 -L 4 , hip, radius 33%, and whole body as well as the total body

“…Several studies have reported a marked relationship between thyroid status and bone mineral density (BMD) or fracture risk in healthy individuals as well as in patients with thyroid dysfunction (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Response of biochemical markers of bone turnover to oral glucose load in diseases that affect bone metabolism

Yavropoulou¹,

Tomos²,

Tsekmekidou³

et al. 2011

Objective: Postprandial suppression of bone resorption is considered one of the main contributors in the circadian rhythm of bone turnover markers. The aim of this study was to investigate this physiological response of bone tissue in diseases that affect bone metabolism. Patients and methods: In this study, 118 patients (45 hypothyroid, 40 hyperthyroid, and 33 b-thalassemic patients) and 78 healthy individuals matched for age and body mass index were included. An oral glucose test (75 g glucose) was performed after overnight fasting. Serum levels of procollagen type-I N-terminal propeptide (P1NP), b-C-terminal telopeptide of type I collagen (b-CTX), and osteocalcin were assayed at 0, 60, and 120 min. Results: Baseline values of bone turnover markers were significantly elevated in hyperthyroid and b-thalassemic patients but not in hypothyroid patients compared with the control group. After oral glucose, the levels of b-CTX but not P1NP or osteocalcin were significantly suppressed in all groups (mean change from baseline is 46.9% for b-CTX, 7.9% for P1NP, and 8% for osteocalcin). The percentage change from baseline for b-CTX was significantly augmented in hypothyroidism (52 vs 42%, PZ0.009). Conclusion: The preservation or even augmentation of postprandial suppression of bone resorption in diseases that affect bone metabolism through distinct pathogenetic mechanisms suggests the importance of this physiological response to nutrients for the general homeostasis and functional integrity of the skeleton.