The Relationship between Thyroid Function and Bone Mineral Density in Euthyroid Healthy Subjects in Taiwan

Lin, Jiunn Diann; Pei, Dee; Hsia, Te Lin; Wu, Chung Ze; Wang, Kun; Chang, Ya‐Ling; Hsu, Chun Hsin; Chen, Yen‐Lin; Chen, Kwang Wen; Tang, Sai Hung

doi:10.3109/07435800.2010.514877

Cited by 30 publications

(24 citation statements)

References 15 publications

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“…Similar to the current study, Murphy et al also reported an inverse correlation between fT 4 and BMD by multiple linear regression. Other studies have also demonstrated that women with higher fT 4 levels within the normal reference range have lower BMD, but they found little or no association between BMD and TSH (10,11,12,25). Interestingly, in a study from Taiwan using a similar cross-sectional design in women of comparable age to the current study, no relation was demonstrated between TSH and BMD, while the authors found a significant but weak correlation between BMD and fT 4 in postmenopausal women (11).…”

Section: European Journal Of Endocrinologymentioning

confidence: 45%

“…Other studies have also demonstrated that women with higher fT 4 levels within the normal reference range have lower BMD, but they found little or no association between BMD and TSH (10,11,12,25). Interestingly, in a study from Taiwan using a similar cross-sectional design in women of comparable age to the current study, no relation was demonstrated between TSH and BMD, while the authors found a significant but weak correlation between BMD and fT 4 in postmenopausal women (11). However, because of the inverse relationship between TSH and T 4 that results from negative feedback regulation of the HPT axis (as reviewed elsewhere (5, 10)), it is not possible to make a distinction between the physiological importance of higher fT 4 levels compared with lower TSH levels.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…Only a few studies have investigated a possible effect of the fT 4 concentration in subclinical thyroid dysfunction (10,11,12), which by definition lies within the reference range. Moreover, it is possible that the subjects with subclinical hyperthyroidism and a fT 4 level in the upper normal range have more adverse clinical outcomes than the subjects with subclinical hyperthyroidism and fT 4 levels in the middle or lower reference range, or compared with euthyroid individuals (3).…”

Section: Introductionmentioning

confidence: 99%

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Low bone mineral density is related to high physiological levels of free thyroxine in peri-menopausal women

Rijn

Pop

Williams

2014

European Journal of Endocrinology

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Objective: To determine whether thyroid hormone (free thyroxine (fT 4 )) rather than TSH is directly related to bone mineral density (BMD). Design: Cross-sectional population cohort study of peri-menopausal women. Methods: Of a sample of 6846 peri-menopausal Dutch women who participated in an osteoporosis-screening programme, a cohort of 2584 was randomly selected for the assessment of thyroid function (TSH, fT 4 and thyroid peroxidase antibodies (TPO-Abs)). TPO-Ab-positive women, with a previous history of thyroid dysfunction, overt thyroid disease, subclinical hypothyroidism, osteoporosis or bilateral oophorectomy and those receiving thyroid hormone or hormone replacement therapy were excluded. Of 1477 eligible women, 1426 had TSH and fT 4 within the reference range and 51 had low or undetectable serum TSH. BMD was measured at the lumbar spine and low BMD was defined as !0.937 g/cm 2 .Results: The mean BMD in the 51 women with low or undetectable serum TSH was 0.984 g/cm 2 compared with 1.001 g/cm 2 in the remaining 1426 (tZ0.94, PZ0.35); 33% of women with low or undetectable serum TSH had low BMD compared with 34% in 1426 euthyroid women. High fT 4 but not low TSH in euthyroid women was related to low BMD by multiple logistic regression corrected for age, BMI and smoking (OR, 1.30; 95% CI, 1.02-1.69). Conclusions: Higher fT 4 levels within the normal reference range but not low or undetectable serum TSH were independently related to decreased BMD at lumbar spine in peri-menopausal women.

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Section: European Journal Of Endocrinologymentioning

confidence: 45%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Low bone mineral density is related to high physiological levels of free thyroxine in peri-menopausal women

Rijn

Pop

Williams

2014

European Journal of Endocrinology

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“…In the Rotterdam study of 1151 euthyroid men and women aged over 55 years, femoral neck BMD correlated positively with TSH and negatively with fT 4 (van der Deure et al 2008). A recent large Taiwanese study of 2957 euthyroid healthy male and female individuals over 45 years of age again reported a negative correlation between BMD and fT 4 but found no correlation with TSH (Lin et al 2011). A cross-sectional study of 677 healthy young men studied at the time of peak bone mass (25-45 years) reported that higher concentrations of fT 3 and Murphy et al 2010).…”

Section: Skeletal Effects Of Thyroid Hormone Concentrations In the Upmentioning

confidence: 99%

The skeletal consequences of thyrotoxicosis

Nicholls¹,

Brassill²,

Williams³

et al. 2012

Journal of Endocrinology

107

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Euthyroid status is essential for normal skeletal development and the maintenance of adult bone structure and strength. Established thyrotoxicosis has long been recognised as a cause of high bone turnover osteoporosis and fracture but more recent studies have suggested that subclinical hyperthyroidism and long-term suppressive doses of thyroxine (T 4 ) may also result in decreased bone mineral density (BMD) and an increased risk of fragility fracture, particularly in postmenopausal women. Furthermore, large population studies of euthyroid individuals have demonstrated that a hypothalamicpituitary-thyroid axis set point at the upper end of the normal reference range is associated with reduced BMD and increased fracture susceptibility. Despite these findings, the cellular and molecular mechanisms of thyroid hormone action in bone remain controversial and incompletely understood. In this review, we discuss the role of thyroid hormones in bone and the skeletal consequences of hyperthyroidism.

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“…A normal or high normal TSH level is known to preserve the BMD [9]. Hormone replacement therapy and calcium supplementation are presently available as the therapeutic modalities for the postmenopausal complications [10]. In addition to this, an early detection and correction of the abnormal TSH levels could help in the prevention of these complications which are observed in PMW [4,8].…”

Section: Introductionmentioning

confidence: 99%

Role of TSH on Urinary Calcium Excretion In Post Menopausal Women of South Indian Population

Niranjan¹,

Amrutha²,

Srinivasan³

et al. 2013

JCDR

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Background: Unforeseen aberrations in the hormonal status during the early postmenopausal period are responsible for several complications including osteoporosis. Thyroid Stimulating Hormone (TSH) receptors are isolated from various tissues including the bone. A low serum TSH level is known to stimulate osteoclastic activity in bone and accelerate bone resorption. Urinary calcium/creatinine (UCa/Cr) excretion ratio could be an indirect and an early indicator of loss of Bone Mineral Density (BMD). With this background, this study was planned to explore the association of serum TSH levels with the UCa/Cr excretion ratio.Methods: Forty eight women in the postmenopausal age group, with their menopausal age not more than seven years of duration were included in this study. Based on their TSH values, these subjects were divided into two groups A (TSH<0.5 mIU/L) and B (TSH>0.5mIU/L). Urinary calcium, UCa/Cr excretion ratio, serum phosphorous, calcium and calcium phosphorous multiplication products were estimated and compared between the two groups.Results: Twenty two (46%) women were biochemically asymptomatic hyperthyroid cases and Twenty six (54%) were euthyroid. This study documents high UCa/Cr in Group A compared to that of Group B (p<0.05). We also observed significant negative correlation of TSH with UCa/Cr excretion ratio (p=0.041, r = -0.43). Conclusion:Low serum TSH levels were associated with increased UCa/Cr excretion ratio in postmenopausal women of South Indian population.NiraNjaN G, amrutha P V, SriNiVaSaN a r, rameSh r, SathiShbabu m, Sathiya r

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The Relationship between Thyroid Function and Bone Mineral Density in Euthyroid Healthy Subjects in Taiwan

Cited by 30 publications

References 15 publications

Low bone mineral density is related to high physiological levels of free thyroxine in peri-menopausal women

Low bone mineral density is related to high physiological levels of free thyroxine in peri-menopausal women

The skeletal consequences of thyrotoxicosis

Role of TSH on Urinary Calcium Excretion In Post Menopausal Women of South Indian Population

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