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Effects of thyrotropin suppression on lumber bone mineral density in postmenopausal women with differentiated thyroid carcinoma

Authors Zhang P, Xi H, Yan R

Received 16 April 2018

Accepted for publication 2 September 2018

Published 9 October 2018 Volume 2018:11 Pages 6687—6692

DOI https://doi.org/10.2147/OTT.S171282

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 4

Editor who approved publication: Professor Jianmin Xu


Pei Zhang,1 Hui Xi,2 Ruihong Yan3

1Department of Endocrinology, Liaocheng People’s Hospital, Liaocheng, Shandong, China; 2Department of Oncology, Liaocheng People’s Hospital, Liaocheng, Shandong, China; 3Department of Nuclear Medicine, Liaocheng People’s Hospital, Liaocheng, Shandong, China

Purpose: The aim of this study was to evaluate the effect of postoperative thyroid-stimulating hormone suppression (TSHS) on bone mineral density (BMD) in Chinese postmenopausal women with differentiated thyroid carcinoma (DTC).
Patients and methods: A total of 225 postmenopausal women with DTC who had received TSHS were included in the study. Postmenopausal women with postoperative DTC undergoing thyroid residual ablation or metastasis treatment between 2009 and 2015 were enrolled and followed up for 2 years. They were divided into two groups: TSHS group (median thyroid-stimulating hormone [TSH] <0.3 µIU/mL) and postmenopausal control group (median TSH >0.3 µIU/mL). Lumbar 1–4 BMD levels were measured by a dual-energy X-ray absorptiometry (DXA) at baseline and 6, 12 and 24 months. All patients had calcium and vitamin D supplementation. The diagnosis of osteopenia (-1 SD > T >-2.5 SD) and osteoporosis (T <-2.5 SD) was made according to WHO guidelines.
Results: Thyroid cancers included 211 papillary carcinomas and 14 follicular carcinomas. One hundred and fifty-four patients were in the TSHS group, and 71 patients were in the non-suppressed TSH group (postmenopausal controls). No significant differences were found in the BMD of the lumbar spine between baseline and after 6, 12 and 24 months, pre and post treatment in TSHS and non-suppressed TSH patients. Compared with pre-TSHS, there was a reduction in the BMD of 1.9% in the lumbar spine at the 2-year follow-up. Significant difference in the number of osteopenia and osteoporosis patients at 24 months (χ2=2.88, P=0.004) was found between the TSHS (103/152) and postmenopausal control (32/68) groups. TSHS is not a significant risk of bone loss, but it is the incidence of osteopenia in postmenopausal women with DTC.
Conclusion: Our 2-year follow-up data indicated that TSHS had little effect on BMD in postmenopausal women with DTC. Large population with at least 5-year follow-up should be further investigated. BMD in postmenopausal women with DTC should be followed up regularly.

Keywords: differentiated thyroid carcinoma, thyroid-stimulating hormone suppression, bone mineral density, postmenopausal women, osteopenia

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