Risk Factors for Predicting Osteoporosis in Patients Who Receive Thyrotropin Suppressive Levothyroxine Treatment for Differentiated Thyroid Carcinoma
Journal Title: Molecular Imaging and Radionuclide Therapy - Year 2019, Vol 28, Issue 2
Abstract
Objectives: Endogenous hyperthyroidism accelerates bone turnover and shortens the normal bone remodeling cycle, which results in reduced bone density. It is estimated that suppressive levothyroxine (LT4) therapy also decreases bone density. The aim of this study was to define risk factors for osteoporosis development in patients under thyrotropin-stimulating hormone (TSH) suppressive treatment for differentiated thyroid cancer (DTC). Methods: Patients with a diagnosis of low or intermediate risk group DTC according to the American Thyroid Association 2015 guidelines and who have been receiving LT4 suppression therapy and were physically fit to undergo femur and lumbar vertebra bone density study were included in the study. Patients lacking information on demographic data, medical history, preoperative thyroid hormone status, or routine follow-up data were excluded from the study. A study form consisting of patient information on possible risk factors for osteoporosis such as gender, age, menopausal status, smoking, family history of osteoporosis, preoperative thyroid hormone status, postoperative hypoparathyroidism history, mean serum TSH levels, and duration of TSH suppression was created and filled out for each participant. Bone mineral densitometries of the femur and lumbar vertebrae were measured along with serum vitamin D and parathyroid hormone levels. Results: During TSH suppression (mean 7.2±4.5 years, range: 1-26), osteoporosis was detected in 89 (9.6%) patients. The mean time to develop osteoporosis was significantly different in patients with or without a family history of osteoporosis (15.3±0.4 versus 20.3±0.6 years; p=0.002). Similarly, the mean time to develop osteoporosis for was found to be significantly shorter in postmenopausal patients than that for premenopausal women (18.6±0.7 versus 20.4±0.4 years; p<0.001). Male gender (p<0.001), a family history of osteoporosis (p=0.001) and menopausal state (p<0.001) were identified as independent predictive factors for developing osteoporosis. Conclusion: Postmenopausal women, men, and patients with a family history who receive TSH-suppression treatment have a tendency to develop osteoporosis.
Authors and Affiliations
Çiğdem Soydal, Elgin Özkan, Demet Nak, Atilla Halil Elhan, Nuriye Özlem Küçük, Metin Kemal Kır
Keywords
Related Articles
- EP ID EP591707
- DOI 10.4274/mirt.galenos.2019.89410
- Views 84
- Downloads 0
Detection of Squamous Cell Carcinoma Foci in a Patient with Dystrophic Epidermolysis Bullosa in 18F-FDG PET/CT
Dystrophic epidermolysis bullosa (DEB) is a rare, inherited skin fragility disorder characterized by blister formation in the sublamina densa. DEB is associated with aggressive squamous cell carcinoma (SCC) that has incr...
Primary Thyroid Lymphoma: External Beam Radiation Therapy Induced Thyroiditis Mimics Residual Disease on Serial 18F-FDG PET/CT Imaging
A 67-year-old female patient with no prior history of benign thyroid disease was diagnosed with primary thyroid lymphoma and was staged with 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed to...
Splenosis Mimicking Lymphoma Relapse Confirmed by 18F-FDG PET/CT and Tc-99m Nano-colloid Scintigraphy Thirty Years After Splenectomy for Trauma
Splenosis is implantation of the splenic tissue in the abdominal region or elsewhere in the body as a consequence of trauma or splenectomy, which might mimic intra-abdominal involvement of several malignancies. This case...
Bone Single Photon Emission/Computed Tomography in the Detection of Sacroiliitis in Seronegative Spondyloarthritis: A Comparison with Magnetic Resonance Imaging
Objective: Seronegative spondyloarthritis (SpA) is characterized by chronic inflammation affecting the axial skeleton, entheses and occasionally peripheral joints. The involvement of the sacroiliac joints, sacroiliitis,...
Thyroid Incidentalomas on 18F-FDG PET/CT: Clinical Significance and Controversies
Objective: The purpose of the current study is to examine the incidence and clinical significance of unexpected focal uptake of 18F-fluorodeoxyglucose (18F-FDG) on positron emission tomography/computed tomography (PET/CT...